Clinical presentation and management in acute toluene intoxication: a case series.
BACKGROUND
Toluene inhalation is a common form of drug abuse throughout the world. Acute toluene toxicity causes neurological changes as well as various metabolic alterations. Hypokalemic paralysis and renal failure are life-threatening complications.


OBJECTIVE
To identify the clinical and metabolic alterations associated with toluene intoxication.


METHODS
We retrospectively analyzed the records of 22 patients that were admitted to a single center's emergency department from 2006 to 2012 with clinical and metabolic alterations due to toluene inhalation.


RESULTS
Of the 22 patients, 77% were male and mean age was 23.5 years (range: 17-30). The main clinical presentation was weakness associated to severe hypokalemia. Severe metabolic acidosis was found in 20 patients. Renal tubular acidosis was diagnosed in five patients. The patients responded to supportive measures and aggressive potassium repletion. Prognosis was generally good.


CONCLUSIONS
Toluene inhalation is associated with various severe metabolic alterations. Treatment guidelines are needed considering the frequency of toluene inhalation in the population.
Departamento de Medicina Interna. Hospital Universitario Dr. José E. González, Universidad Autónoma de Nuevo León, Madero y Gonzalitos S/N, Monterrey, Nuevo León 64460, México. crcamara83@hotmail.com
Carlos Rodrigo
CR
Cámara-Lemarroy
Emanuel Irineo
EI
Gónzalez-Moreno
Rene
R
Rodriguez-Gutierrez
José Gerardo
JG
González-González
D000138:Acidosis / Q000139:chemically induced*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000139:chemically induced* / Q000150:complications; D058545:Inhalant Abuse / Q000150:complications*; D008297:Male; D018908:Muscle Weakness / Q000209:etiology; D010243:Paralysis / Q000209:etiology; D014050:Toluene / Q000506:poisoning*; D055815:Young Adult
D014050:Toluene