title: Clinical features, laboratory findings and imaging appearances of venous diethylene glycol poisoning in patients with liver disease.
abstract: BACKGROUND
  There was a hospital outbreak of venous diethylene glycol poisoning in Guangzhou, China. It is the only massive episode of venous diethylene glycol poisoning in history. Here we report its clinical features, laboratory findings, and imaging appearances.
  
  
  METHODS
  The clinical features of 15 venous diethylene glycol poisoning patients with liver disease were analyzed and summarized. Their laboratory findings and imaging appearances were comparatively analyzed before and after poisoning.
  
  
  RESULTS
  All poisoned patients presented with oliguric acute renal failure with anuria after a mean of 6 days. Carbon dioxide combination power of 13 patients dropped after a mean of 9 days with valley value on the 10th day, when metabolic acidosis developed. Gastroenteric symptoms or aggravation of gastroenteric symptoms were displayed in 11 patients after a mean of 9 days. Neurological system impairment was observed in 10 patients after a mean of 14 days. Seven patients had low fever after a mean of 6 days. Causes of death of 14 patients included multiple organ dysfunction syndrome, severe lung infection and massive haemorrhage of digestive tract. Blood creatinine and urea nitrogen were abnormal after a mean of 5 days with peak value on the 11th and 14th days, respectively. Serum calcium had no obvious change, and phosphorus was distinctively increased. Liver functions did not change significantly. Poisoned patients had higher white blood cell counts, but lower red blood cell counts and hemoglobin value. Of the 7 patients who exhibited mild, moderate or severe patchy consolidation shadowing in the lung, 2 manifested mild or severe gaseous distention and dilation of gastroenteric tract.
  
  
  CONCLUSIONS
  Main features of venous diethylene glycol poisoning in patients with liver disease include oliguric acute renal failure, metabolic acidosis, gastroenteric symptoms or aggravation of gastroenteric symptoms, neurological system impairment and low fever, with a mortality rate of 93.33% in poisoned patients. There is also higher white blood cell counts and anemia, patchy consolidation shadowing in the lung, gaseous distention and dilation of gastroenteric tract, which occurs later than mild patchy consolidation shadowing and earlier than moderate patchy consolidation shadowing in the lung.
authors.affiliation: Department of Radiology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510655, China. myluo720@163.com
authors.forename: Ming-yue
authors.initials: MY
authors.lastname: Luo
authors.forename: Bing-liang
authors.initials: BL
authors.lastname: Lin
authors.forename: Zhi-liang
authors.initials: ZL
authors.lastname: Gao
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced; D000293:Adolescent; D000328:Adult; D000368:Aged; D001578:Benzopyrans / Q000506:poisoning*; D002648:Child; D002675:Child, Preschool; D004340:Drug Contamination; D005026:Ethylene Glycols / Q000506:poisoning*; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
chemical_list: D001578:Benzopyrans; D005026:Ethylene Glycols; C013484:diethylene glycol; C023435:armillarisin A