5-Oxoproline as a cause of high anion gap metabolic acidosis: an uncommon cause with common risk factors

Neth J Med. 2008 Sep;66(8):354-7.


High anion gap metabolic acidosis might be caused by 5-oxoproline (pyroglutamic acid). As it is very easy to treat, it might be worth drawing attention to this uncommon and probably often overlooked diagnosis. We present three cases of high anion gap metabolic acidosis due to 5-oxoproline seen within a period of six months.

Publication types

  • Case Reports

MeSH terms

  • Acid-Base Equilibrium*
  • Acidosis, Renal Tubular / chemically induced*
  • Acidosis, Renal Tubular / etiology
  • Aged
  • Female
  • Humans
  • Malnutrition
  • Middle Aged
  • Pyrrolidonecarboxylic Acid / adverse effects*
  • Renal Insufficiency
  • Risk Factors


  • Pyrrolidonecarboxylic Acid