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Intentional infantile ethylene glycol poisoning presenting as an inherited metabolic disorder
A D Woolf1, A Wynshaw-Boris, P Rinaldo
1Program in Clinical Pharmacology and Toxicology, Children's Hospital, Boston, Massachusetts.
Insights
Ethylene glycol poisoning in infants can cause recurrent metabolic acidosis. Early detection is crucial, as the toxic substance was found in the baby's formula and blood.
Area of Science:
- Pediatrics
- Toxicology
- Metabolic Disorders
Background:
- Infantile metabolic acidosis is a serious condition requiring prompt diagnosis.
- Recurrent unexplained metabolic derangements in infants warrant thorough investigation.
Observation:
- A 6-month-old infant presented with recurrent episodes of irritability, vomiting, acidosis, and hypotonia.
- During the third hospitalization, laboratory tests revealed hyperglycinemia and elevated urinary glycolic acid levels.
Findings:
- Ethylene glycol was identified in both the infant's bloodstream and the prepared formula.
- The clinical presentation and laboratory findings were consistent with ethylene glycol intoxication.
Implications:
- Ethylene glycol poisoning should be considered in the differential diagnosis of recurrent metabolic acidosis in infants.
- Environmental and dietary sources of toxins must be evaluated in cases of unexplained pediatric illness.
- This case highlights the importance of comprehensive toxicological screening in critically ill infants.
Abstract:
A 6-month-old girl was hospitalized on three occasions for irritability, vomiting, acidosis, and hypotonia. During the third hospitalization hyperglycinemia and urinary glycolic acid were detected. Ethylene glycol was discovered in the infant's blood and bottled formula. Clinicians must consider ethylene glycol intoxication as a cause of recurrent infantile metabolic acidosis.