Etiology And Pathophysiology
Diethylene glycol is a solvent and chemical intermediate used frequently in industry. It has been implicated in a number of epidemic poisonings stemming from its use as a solvent in medications and wines.2,8-10,13,14,114-123 Diethylene glycol poisoning has also resulted from accidental or self-harm ingestions of brake fluid, solid cooking fuel, fog solution, domestic cleaning solutions, and wallpaper stripping solution.124-128
After ingestion, diethylene glycol is metabolized by ADH to (2-hydroxyethoxy)acetaldehyde, which is then metabolized by aldehyde dehydrogenase to HEAA.2 HEAA, and possibly other metabolites such as diglycolic acid, are thought to result in toxic effects including central nervous system depression, encephalopathy, neuropathy, paresis, gastrointestinal symptoms, metabolic acidosis, renal failure requiring long-term dialysis, and death.13-14,54,125,127-132 Patients with delayed presentation may be at higher risk of poor outcomes.127
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