Case Presentation: Pyroglutamic acid (5-oxoproline) is a rare cause of metabolic acidosis most often associated with sub-acute or chronic acetaminophen intake in the presence of unique risk factors. Discussion: A 25-year old female with Crohn’s disease presented with one month of worsening abdominal pain, diarrhea, and anorexia with reported 20 kg weight loss. She developed [...]