Guilty as charged: unmeasured urinary anions in a case of pyroglutamic acidosis

EJ Rolleman, Ewout Hoorn, Paul Didden, R. Zietse

Research output: Contribution to journalArticleAcademicpeer-review

21 Citations (Scopus)


A patient developed an unexplained metabolic acidosis with the characteristics of renal tubular acidosis. By correcting the serum anion gap for hypoalbuminaemia and analysing the urinary anions and cations, the presence of unmeasured anions was revealed. The diagnosis of pyroglutamic acidosis, caused by a combination of flucloxacillin and acetaminophen, was established. Strategies for solving complex cases of metabolic acidosis are discussed.
Original languageUndefined/Unknown
Pages (from-to)351-353
Number of pages3
JournalNetherlands Journal of Medicine
Issue number8
Publication statusPublished - 2008

Cite this