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Inhal Toxicol. 2012 Jun;24(7):434-8. doi: 10.3109/08958378.2012.684364.

Clinical presentation and management in acute toluene intoxication: a case series.

Cámara-Lemarroy CR, Gónzalez-Moreno EI, Rodriguez-Gutierrez R, González-González JG.

Source

Departamento de Medicina Interna. Hospital Universitario Dr. José E. González, Universidad Autónoma de Nuevo León, Madero y Gonzalitos S/N, Monterrey, Nuevo León 64460, México. crcamara83@hotmail.com

Abstract

CONTEXT:

Toluene inhalation is a common form of drug abuse throughout the world. Acute toluene toxicity causes neurological changes as well as various metabolic alterations. Hypokalemic paralysis and renal failure are life-threatening complications.

OBJECTIVE:

To identify the clinical and metabolic alterations associated with toluene intoxication.

MATERIALS AND METHODS:

We retrospectively analyzed the records of 22 patients that were admitted to a single center's emergency department from 2006 to 2012 with clinical and metabolic alterations due to toluene inhalation.

RESULTS:

Of the 22 patients, 77% were male and mean age was 23.5 years (range: 17-30). The main clinical presentation was weakness associated to severe hypokalemia. Severe metabolic acidosis was found in 20 patients. Renal tubular acidosis was diagnosed in five patients. The patients responded to supportive measures and aggressive potassium repletion. Prognosis was generally good.

CONCLUSION:

Toluene inhalation is associated with various severe metabolic alterations. Treatment guidelines are needed considering the frequency of toluene inhalation in the population.

PMID: 22642292 [PubMed - indexed for MEDLINE]

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Hong Kong Med J. 2005 Feb;11(1):50-3.

Renal tubular acidosis and severe hypophosphataemia due to toluene inhalation.

Tang HL, Chu KH, Cheuk A, Tsang WK, Chan HW, Tong KL.

Source

Division of Nephrology, Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Kowloon, Hong Kong. pmhrenal@hotmail.com

Abstract

A 21-year-old woman developed severe muscle paralysis after sniffing toluene-containing thinner solution for 2 weeks. Her serum chemistries revealed severe hypokalaemia and a normal anion gap hyperchloraemic metabolic acidosis secondary to renal tubular acidosis. Her initial presentation mimicked hypokalaemic periodic paralysis, but toxicology screening of her blood and urine revealed the correct diagnosis of toluene poisoning. Her electrolyte and acid-base status returned to normal 4 days after cessation of toluene sniffing. On another occasion, apart from renal tubular acidosis, the patient also developed severe hypophosphataemia with the phosphate level decreasing to 0.15 mmol/L. Hypophosphataemia with such a low phosphate level after toluene poisoning has been rarely reported in the literature. Toluene inhalation can result in multiple electrolyte and acid-base abnormalities, and should be considered in the diagnosis of any young patient who presents with unexplained hypokalaemia and normal anion gap metabolic acidosis.

PMID: 15687517 [PubMed - indexed for MEDLINE] Free full text

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J Intensive Care Med. 2004 Jul-Aug;19(4):183-93.

Acute respiratory failure from abused substances.

Wilson KC, Saukkonen JJ.

Source

Pulmonary Center, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts 02118, USA.

Abstract

Acute respiratory failure is a common complication of drug abuse. It is more likely to develop in the

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