MD, PhD, Department of Internal Medicine, Zuyderland Medical Centre, Sittard/Heerlen, The Netherlands.
PhD, Laboratory for Clinical Chemistry and Haematology, Zuyderland Medical Centre, Sittard/Heerlen, The Netherlands.
Acute Med. 2022;21(1):47-49. doi: 10.52964/AMJA.0892.
High anion gap metabolic acidosis (HAGMA) is a common diagnosis in the emergency department, which requires a systematic work-up in order to identify and treat the underlying cause. We present an unusual case of HAGMA due to 5-oxoproline accumulation caused by prolonged treatment with both acetaminophen (paracetamol) and flucloxacillin. This paper describes the diagnostic work-up of HAGMA and emphasizes on the approach and initial treatment in case the underlying etiology is unclear.
高阴离子间隙代谢性酸中毒（HAGMA）是急诊科的常见诊断，需要进行系统的检查以确定并治疗潜在病因。我们报告了一例因长期使用对乙酰氨基酚（扑热息痛）和氟氯西林导致 5-氧脯氨酸积累而引起的 HAGMA 不常见病例。本文描述了 HAGMA 的诊断检查，并强调了在潜在病因不明的情况下的处理方法和初始治疗。
