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[High anion gap metabolic acidosis (pyroglutamic acidosis) induced by chronic acetaminophen use]
J Tchougang Nono1, V Mistretta2, I Noirot2
1Service Anesthésie-Réanimation, Service de Soins Intensifs Généraux, CHU, Site Sart Tilman, Liège, Belgique.
Abstract:
Acetaminophen is the most consumable analgesic in the world in the form of medical prescription or self-medication. It is one of the active ingredients most often involved in voluntary poisoning. Lethal dose of acetaminophen classically induces acute hepatic failure on hepatic necrosis. Chronic intake of sub-lethal doses (i.e. near recommended therapeutic doses) of acetaminophen in the presence of certain risk factors may be responsible for another much less recognized pathological manifestation: severe metabolic acidosis with an increased anion gap due to the accumulation of 5-oxoproline or pyroglutamic acid.
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