Detection of isopropanol in acetonemic patients not exposed to isopropanol

Isopropanol has been identified in five acetonemic patients not exposed to this compound. Serum concentrations ranged up to 297 mg/L for IPA and up to 321 mg/L for acetone. Concentration ratios (isopropanol:acetone) ranged up to 5.12. All five patients had Type I diabetes mellitus and were insulin-dependent. At the time isopropanol was detected each patient was hyperglycemic, and four patients were acidotic. These findings tend to corroborate clinically some earlier autopsy reports that acetone may be converted to isopropanol in physiological conditions in which reduced nicotinamide adenine dinucleotide is elevated. The conversion of acetone to isopropanol in vivo has significant clinical and forensic toxicological implications.