Gupta Avneesh, Diaz Francisco J, Lal Anita, Sung Lokman, Aaron Cynthia K
From the *Department of Pathology, †Department of Pathology, University of Michigan, Detroit, MI; ‡Forensic Services and Coroner's Complex, Provincial Forensic Pathology, Toronto, Ontario, Canada; §Department of Pathology, University of Michigan, Ann Arbor; and ∥Michigan Regional Poison Control Center, Children's Hospital of Michigan, Detroit, MI.
Am J Forensic Med Pathol. 2017 Mar;38(1):39-42. doi: 10.1097/PAF.0000000000000295.
Diethylene glycol (DEG), an organic compound (HOCH2CH2)2O is a commonly used solvent. Mass poisoning outbreaks have been reported because of frequent contaminations. A PubMed search for diethylene resulted in 795 publications with 151 specifically discussing the toxicity. Of the 151 reported toxicity reviews/case reports, only 6 publications discussed the long-term neurological effects of diethylene toxicity. We report a fatal case of oral ingestion of DEG with complications from delayed toxicity. She died 7 days after the second admission. Autopsy disclosed a right basal ganglia hemorrhage within the brain and microscopic deposits of polarizable crystals into small cerebral blood vessels. Both kidneys illustrate tubular necrosis with scattered tubular deposition of polarizable calcium oxalate crystals. PubMed search leads to only 2 reported cases of basal ganglia hemorrhage (based on radiological findings) after ethylene glycol intoxication. Our case is the first reportable case of basal ganglia hemorrhage after DEG ingestion.
二甘醇(DEG),一种有机化合物(HOCH2CH2)2O,是一种常用溶剂。由于频繁污染,已报告发生大规模中毒事件。在PubMed上搜索二甘醇,得到795篇出版物,其中151篇专门讨论了其毒性。在这151篇报告的毒性综述/病例报告中,只有6篇讨论了二甘醇毒性的长期神经影响。我们报告一例口服二甘醇致死病例,伴有迟发性毒性并发症。她在第二次入院7天后死亡。尸检发现脑内右侧基底节出血,小脑血管内有可极化晶体的微观沉积。双侧肾脏均显示肾小管坏死,伴有散在的可极化草酸钙晶体肾小管沉积。PubMed搜索仅发现2例乙二醇中毒后基底节出血的报告病例(基于影像学检查结果)。我们的病例是首例二甘醇摄入后基底节出血的可报告病例。