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Epidemics of acute renal failure in children (diethylene glycol toxicity)

Saad Alkahtani1, Helen Sammons, Imti Choonara

  • 1Academic Division of Child Health, University of Nottingham, Derbyshire Children's Hospital, Uttoxeter Road, Derby DE22 3DT, UK; mzxsa2@nottingham.ac.uk

Archives of Disease in Childhood
|November 11, 2010
PubMed

Insights

Diethylene glycol (DEG) poisoning has caused epidemics of acute renal failure in children, leading to severe symptoms and over 300 deaths globally. Prompt recognition and removal of contaminated products are crucial for saving lives.

Area of Science:

  • Pediatric Nephrology
  • Toxicology
  • Public Health

Background:

  • Acute renal failure (ARF) in children presents diverse etiologies.
  • Several epidemics of ARF in young children were linked to diethylene glycol (DEG) poisoning.
  • DEG poisoning has resulted in significant mortality, exceeding 300 deaths worldwide.

Purpose of the Study:

  • To highlight the clinical presentation of diethylene glycol (DEG) poisoning in pediatric patients.
  • To emphasize the public health implications of DEG contamination in pharmaceutical products.
  • To underscore the urgency of recognizing and responding to DEG-induced renal failure.

Main Methods:

  • Review of documented cases and epidemiological data of DEG poisoning outbreaks in children.
  • Analysis of clinical manifestations including gastrointestinal bleeding, seizures, and liver failure alongside renal failure.
  • Investigation into the sources of DEG contamination, including pharmaceutical adulteration and illicit solvent use.

Main Results:

  • Children poisoned with DEG exhibit a distinct clinical syndrome including renal, hepatic, and gastrointestinal compromise.
  • Epidemics were traced to contaminated medicines and the illicit use of DEG as a solvent.
  • Over 300 pediatric deaths globally attributed to diethylene glycol poisoning.

Conclusions:

  • Diethylene glycol poisoning is a critical cause of acute renal failure in children, often presenting with multi-organ involvement.
  • Awareness among health professionals regarding the clinical signs of DEG poisoning is vital for timely intervention.
  • Rapid removal of contaminated or illicitly used DEG-containing products from circulation is essential to prevent further fatalities.

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