{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T22:59:12Z","timestamp":1793314752018,"version":"4.5.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJEM"],"published-print":{"date-parts":[[2010,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The workup of the emergency patient with a raised anion gap metabolic acidosis includes assessment of the components of \u201cMUDPILES\u201d (methanol; uremia; diabetic ketoacidosis; paraldehyde; isoniazid, iron or inborn errors of metabolism; lactic acid; ethylene glycol; salicylates). This approach is usually sufficient for the majority of cases in the emergency department; however, there are many other etiologies not addressed in this mnemonic. Organic acids including 5-oxoproline (pyroglutamic acid) are rare but important causes of anion gap metabolic acidosis. We present the case of a patient with profound metabolic acidosis with raised anion gap, due to pyroglutamic acid in the setting of malnutrition and chronic ingestion of acetaminophen.<\/jats:p>","DOI":"10.1017\/s148180350001263x","type":"journal-article","created":{"date-parts":[[2016,7,15]],"date-time":"2016-07-15T02:02:47Z","timestamp":1468548167000},"page":"449-452","source":"Crossref","is-referenced-by-count":13,"title":["Profound metabolic acidosis from pyroglutamic acidemia: an underappreciated cause of high anion gap metabolic acidosis"],"prefix":"10.1007","volume":"12","author":[{"given":"Thomas J.","family":"Green","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Jaap","family":"Bijlsma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D.","family":"Sweet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2015,5,21]]},"reference":[{"key":"S148180350001263X_ref022","first-page":"953","volume":"46","year":"1993","journal-title":"Biochem Pharmacol"},{"key":"S148180350001263X_ref023","doi-asserted-by":"publisher","DOI":"10.1177\/0115426505020006634"},{"key":"S148180350001263X_ref020","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/0016-5085(89)90081-4","volume":"97","year":"1989","journal-title":"Gastroenterology"},{"key":"S148180350001263X_ref009","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1093\/clinchem\/44.2.336","volume":"44","year":"1998","journal-title":"Clin Chem"},{"key":"S148180350001263X_ref008","first-page":"1452","volume":"1","year":"1989","journal-title":"Lancet"},{"key":"S148180350001263X_ref007","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200006000-00018"},{"key":"S148180350001263X_ref006","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1093\/clinchem\/44.7.1497","volume":"44","year":"1998","journal-title":"Clin Chem"},{"key":"S148180350001263X_ref005","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01411005"},{"key":"S148180350001263X_ref004","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1093\/clinchem\/35.4.684","volume":"35","year":"1989","journal-title":"Clin Chem"},{"key":"S148180350001263X_ref003","doi-asserted-by":"publisher","DOI":"10.1007\/BF02263605"},{"key":"S148180350001263X_ref002","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1981.tb16556.x"},{"key":"S148180350001263X_ref001","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.71.6.2505"},{"key":"S148180350001263X_ref019","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.3.5722.557"},{"key":"S148180350001263X_ref018","volume":"46","year":"2005","journal-title":"Am J Kidney Dis"},{"key":"S148180350001263X_ref017","doi-asserted-by":"publisher","DOI":"10.1007\/BF01799581"},{"key":"S148180350001263X_ref016","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2005.04.010"},{"key":"S148180350001263X_ref015","doi-asserted-by":"publisher","DOI":"10.1007\/BF03160921"},{"key":"S148180350001263X_ref014","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfi184"},{"key":"S148180350001263X_ref013","first-page":"354","volume":"66","year":"2008","journal-title":"Neth J Med"},{"key":"S148180350001263X_ref012","first-page":"351","volume":"66","year":"2008","journal-title":"Neth J Med"},{"key":"S148180350001263X_ref011","doi-asserted-by":"publisher","DOI":"10.1258\/000456307780945769"},{"key":"S148180350001263X_ref010","doi-asserted-by":"crossref","first-page":"223","DOI":"10.5694\/j.1326-5377.2006.tb00537.x","volume":"185","year":"2006","journal-title":"Med J Aust"},{"key":"S148180350001263X_ref021","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.285.6345.851"}],"container-title":["CJEM"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S148180350001263X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T18:35:46Z","timestamp":1609439746000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S148180350001263X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,9]]},"references-count":23,"journal-issue":{"issue":"05","published-print":{"date-parts":[[2010,9]]}},"alternative-id":["S148180350001263X"],"URL":"https:\/\/doi.org\/10.1017\/s148180350001263x","relation":{},"ISSN":["1481-8035","1481-8043"],"issn-type":[{"value":"1481-8035","type":"print"},{"value":"1481-8043","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,9]]}}}