O'Brien L Morgan Nordstrom, Hooper Michael, Flemmer Mark, Marik Paul Ellis
Department of Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA.
BMJ Case Rep. 2012 Jul 3;2012:bcrbcr0320126020. doi: 10.1136/bcr.03.2012.6020.
Anion gap metabolic acidosis is commonly caused by lactic acidosis, ketoacidosis, and ingestion of methanol, salicylates, ethylene glycol or accumulation of organic/inorganic acids. However, rare causes of metabolic acidosis from enzyme defects, such as disturbances in the γ-glutamyl cycle, are being reported in higher frequencies in the adult population. Such disturbances cause an accumulation of 5-oxoproline and ultimately an anion gap metabolic acidosis. These disturbances are often associated with acetaminophen in the setting of certain risk factors such as sepsis, malnutrition, liver disease, female gender, pregnancy or renal failure.
阴离子间隙代谢性酸中毒通常由乳酸酸中毒、酮症酸中毒、甲醇、水杨酸盐、乙二醇摄入或有机/无机酸蓄积引起。然而，成人中因酶缺陷导致的代谢性酸中毒罕见病因，如γ-谷氨酰循环紊乱，报告频率正越来越高。此类紊乱会导致5-氧脯氨酸蓄积，最终引发阴离子间隙代谢性酸中毒。在脓毒症、营养不良、肝病、女性、妊娠或肾衰竭等某些危险因素情况下，这些紊乱常与对乙酰氨基酚有关。
