title: Acute peripheral polyneuropathy with multiorgan failure: a diagnostic dilemma.
abstract: We describe the case of a young man who presented with abdominal pain, vomiting and acute symmetric peripheral polyneuropathy. He was noted to have high anion gap metabolic acidosis with high lactate levels and persistently high arterial and venous pO2 values. The cerebrospinal fluid was acellular with a high protein and the nerve conduction study was consistent with axonal sensorimotor neuropathy. His clinical condition deteriorated rapidly despite full supportive care and he subsequently died of multiorgan failure. An extensive workup for various infectious, autoimmune and other possible aetiologies was carried out to identify the underlying cause for his fulminant illness. All diagnostic workup was non-conclusive except for a significantly elevated serum aluminium level. We have discussed the possibility of aluminium phosphide poisoning in view of the clinical presentation.
authors.affiliation: Department of Internal Medicine, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates.
authors.forename: Kosar
authors.initials: K
authors.lastname: Hussain
authors.affiliation: Department of Medical Intensive Care Unit, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates.
authors.forename: Jawed
authors.initials: J
authors.lastname: Abubaker
authors.affiliation: Department of Neurology, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates.
authors.forename: Javeed Ahmad
authors.initials: JA
authors.lastname: Dar
authors.affiliation: Department of Medical Intensive Care Unit, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates.
authors.forename: Raees
authors.initials: R
authors.lastname: Ahmed
mesh_terms: D000208:Acute Disease; D000535:Aluminum / Q000506:poisoning*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000139:chemically induced / Q000175:diagnosis*; D011115:Polyneuropathies / Q000139:chemically induced / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D000535:Aluminum