title: Coma in a 20-month-old child from an ingestion of a toy containing 1,4-butanediol, a precursor of gamma-hydroxybutyrate.
abstract: Ingestion of plastic toys is common in children and usually does not result in harm. We report a case of coma in a 20-month-old child after an ingestion of a toy containing 1,4-butanediol, an industrial solvent used to manufacture plastics. When ingested, 1,4-butanediol is metabolized to gamma-hydroxybutyrate, which can have significant systemic effects including death. Health care providers should suspect the possibility of a toxic component when a presumed nontoxic object causes unusual symptoms.
authors.affiliation: Section of Critical Care Medicine, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, 800 Marshall St, Slot 512-12, Little Rock, AR 72202, USA. ortmannlauraa@uams.edu
authors.forename: Laura A
authors.initials: LA
authors.lastname: Ortmann
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Jaeger
authors.forename: Laura P
authors.initials: LP
authors.lastname: James
authors.forename: Steve M
authors.initials: SM
authors.lastname: Schexnayder
mesh_terms: D002072:Butylene Glycols / Q000737:chemistry / Q000506:poisoning*; D003128:Coma / Q000139:chemically induced* / Q000175:diagnosis; D003937:Diagnosis, Differential; D004435:Eating; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D009960:Oropharynx / Q000293:injuries*; D010988:Play and Playthings; D011355:Prodrugs; D012978:Sodium Oxybate / Q000032:analysis* / Q000506:poisoning; D013396:Suction
chemical_list: D002072:Butylene Glycols; D011355:Prodrugs; D012978:Sodium Oxybate; C039681:1,4-butanediol