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In order to raise awareness of this condition and the circumstances in which it can occur we present two further case reports of a high anion gap metabolic acidosis caused by acculumation of 5-oxoproline in ICU patients The first case report is one of a 62 year old gentleman with a background history of Crohn’s disease, complicated by an enterocutaneous fistula, and a history of alcohol excess with a weekly alcohol intake of 60-70 units
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