Severe isopropanolemia without acetonemia or clinical manifestations of isopropanol intoxication.
This is the first reported case of severe isopropanolemia in a patient who did not experience associated clinical manifestations and acetonemia. The patient was found lying face down in a hotel lobby but at admission was alert and oriented to place and person. Toxicological analysis of the patient's serum revealed the presence of isopropanol at a concentration of 72 mmol/L. An increased serum osmolal gap (81 mOsm/kg) was also observed. The serum concentration of isopropanol decreased to 9.5 mmol/L 15.5 h after admission with an estimated half-life of elimination of 5-7 h. No serum acetone was detected throughout the patient's hospitalization. The identity of isopropanol was confirmed by gas chromatography/mass spectrometry. The patient remained awake and alert while in the hospital and was discharged 5 days after admission. These unusual findings raise some fundamental questions about the role of isopropanol conversion to acetone in the manifestation of symptoms usually associated with isopropanol intoxication.
Chan
K M
KM
Department of Pathology and Laboratory Medicine, Los Angeles County-University of Southern California Medical Center 90033.
Wong
E T
ET
Matthews
W S
WS
D000433:1-Propanol / Q000097:blood* / Q000506:poisoning*; D000096:Acetone / Q000097:blood; D000328:Adult; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D008297:Male
D000096:Acetone; D000433:1-Propanol