Some patients with acetaminophen (paracetamol) poisoning may develop pyroglutamic acidemia.
Pyroglutamic acidemia may occur:
(1) after a high dose of acetaminophen
(2) therapeutic doses given for several days
Clinical and laboratory features:
(1) metabolic acidosis with high anion gap
(2) depressed level of consciousness
(3) variable malnutrition
(4) normal blood lactate
(5) elevated 5-oxoproline in the urine
(6) exclusion of other conditions that might explain the findings better
