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Metabolic acidosis due to a high anion gap is commonly described by the mnemonic \u2018MUDPILES\u2019 in daily practice. A newer mnemonic, \u2018GOLD MARK\u2019 is proposed to be a more inclusive tool to assist in determining the cause of high anion gap metabolic acidosis, especially with such cases being reported.<\/jats:p>","DOI":"10.1136\/bcr-2023-258396","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T11:56:47Z","timestamp":1714478207000},"page":"e258396","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Analgesia to acidosis: metabolic acidosis due to chronic acetaminophen (paracetamol) use"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9089-5239","authenticated-orcid":false,"given":"Anmol","family":"Goyal","sequence":"first","affiliation":[{"name":"Stanford University, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Gaskill","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Osman","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demetra","family":"Gibson","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,4,30]]},"reference":[{"key":"2025082722091908000_17.4.e258396.1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03020906"},{"key":"2025082722091908000_17.4.e258396.2","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1097\/00005792-197756010-00002","article-title":"Clinical use of the anion gap","volume":"56","author":"Emmett","year":"1977","journal-title":"Medicine"},{"key":"2025082722091908000_17.4.e258396.3","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200006000-00018"},{"key":"2025082722091908000_17.4.e258396.4","first-page":"351","article-title":"Guilty as charged: unmeasured urinary anions in a case of Pyroglutamic acidosis","volume":"66","author":"Rolleman","year":"2008","journal-title":"Neth J Med"},{"key":"2025082722091908000_17.4.e258396.5","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2005.03.021"},{"key":"2025082722091908000_17.4.e258396.6","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2010.33"},{"key":"2025082722091908000_17.4.e258396.7","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1093\/clinchem\/44.7.1497","article-title":"Transient 5-Oxoprolinuria and high anion gap metabolic acidosis: clinical and biochemical findings in eleven subjects","volume":"44","author":"Pitt","year":"1998","journal-title":"Clin Chem"},{"key":"2025082722091908000_17.4.e258396.8","article-title":"Severe anion gap metabolic acidosis resulting from combined chronic acetaminophen toxicity and starvation ketosis: A case report and literature review","volume":"23","author":"Kalinoski","year":"2022","journal-title":"Am J Case Rep"},{"key":"2025082722091908000_17.4.e258396.9","first-page":"354","article-title":"5-Oxoproline as a cause of high anion gap metabolic acidosis: an uncommon cause with common Riskfactors","volume":"66","author":"Kortmann","year":"2008","journal-title":"Neth J Med"},{"key":"2025082722091908000_17.4.e258396.10","doi-asserted-by":"publisher","DOI":"10.1079\/BJN19870088"},{"key":"2025082722091908000_17.4.e258396.11","first-page":"265","article-title":"Postoperative pain relief and functional outcome following total knee Arthroplasty - 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