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Consider in Differential Diagnosis: When a patient on a GLP-1 or GIP/GLP-1 medication presents with new-onset neuropathic pain or sensory abnormalities, consider the medication as a potential cause

The diagnosis of paracetamol related pyroglutamic acidosis was made after ruling out the main causes of metabolic acidosis

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Valproyl metabolites trap mitochondrial CoA which leads to decreased ATP production, further depleting carnitine since ATP is needed for the carnitine transporter to work