Delayed Neurologic Sequelae Resulting from Epidemic Diethylene Glycol Poisoning

Abstract

Unrecognized DEG poisoning may present with metabolic acidemia and anuric acute renal failure. Established renal impairment may predict subsequent delayed neurologic toxicity.

Medical toxicology and public health—Update on research and activities at the centers for disease control and prevention and the agency for toxic substances and disease registry

“…The acute short-and long-term adverse health effects of exposure to DEG are not well established. To the authors' knowledge, no detailed follow-up information on outcomes of DEG-poisoned patients exists, other than a brief report on a case series of five patients [5]. Of these five, three were severely ill on presentation, and one died shortly thereafter.…”

“…Of these five, three were severely ill on presentation, and one died shortly thereafter. The remaining two had improved neurologic function at 4-6 months after presentation, but remained dialysis-dependent and displayed persistent neurologic deficits at 26 months [5]. Considering the large number of potentially exposed individuals, it is conceivable that there might be a large future DEG-associated disease burden in the Republic of Panama.…”

“…Diethylene glycol (DEG), or 2,2'-dihydroxydiethyl ether, is an alcohol produced by the condensation of two ethylene glycol (EG) molecules with an ether bond [5]. It was first isolated as early as 1869 and has been used in industry and manufacturing since 1928 [5].…”

“…It was first isolated as early as 1869 and has been used in industry and manufacturing since 1928 [5]. Since then it has been used as an antifreeze solution; as a finishing agent for wool, cotton, silk, and other fabrics; and in dye manufacturing.…”

“…Patients typically develop acute renal failure (ARF) and may present with metabolic acidosis [5]. In several medicationassociated DEG mass poisonings, the clinical picture included ARF and neurologic symptoms, including encephalopathy, coma, and death [10][11][12].…”