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2 5-oxoproline accumulation occurs due to a defect in the -glutamyl cycle

economy about $18$51 billion annually 5,6,7,8

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Medications: antibiotics and certain inflammation reducers, like nonsteroidal anti-inflammatory drugs (NSAIDs) Medical treatments: radiation therapy or blood transfusions Physical stimuli: exercise, tight clothing, or exposure to heat, cold, or sunlight Viral infections: mononucleosis, COVID19, and hepatitis Bacterial infections: strep throat and urinary tract infections Allergic reactions to latex, nickel, insect bites or stings, and certain foods can also produce acute hives