Pyroglutamic acidemia and aciduria (5-oxoprolinuria) may be caused by a range of conditions.
Hereditary conditions associated with pyroglutamic acidemia and aciduria:
(1) glutathione synthetase deficiency (GSD)
(2) 5-oxoprolinase deficiency
(3) other enzyme deficiencies in the gamma-glutamyl cycle
(4) neonatal urea cycle defect
(5) tyrosinemia type I
(6) propionic acidemia
(7) methylmalonic acidemia
Acquiredconditions associated with pyroglutamic acidemia and aciduria:
(1) malnutrition (with depletion of body stores of glutathione)
(2) Stevens-Johnson syndrome
(3) extreme prematurity
(4) sepsis
(5) liver or renal failure
(6) pregnancy
(7) alcohol abuse
Drug-related:
(1) acetaminophen (especially at high doses)
(2) vigabatrin
(3) flucloxacillin
(4) netilmicin
