Pyroglutamic acidemia and aciduria is cause of metabolic acidosis
Pyroglutamic acid is also known as 5-oxoprolinate. It is a derivative of glutamic acid or glutamine that cyclizes to form a lactam.
Clinical features:
(1) altered mental status
(2) tachypnea
(3) nausea and vomiting
(4) anorexia
(5) malaise
Laboratory features:
(1) metabolic acidosis with a high anion gap
(2) urine with >= 150 mmol 5-oxoproline per mol creatinine
(3) exclusion of types of metabolic acidosis
(4) variable hemolytic anemia
