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Propylene glycol toxicity from compulsive corn starch ingestion
J Peterson1, R Stadlen2, J Radke3
1Wake Forest Department of Ophthalmology, 475 Vine Street, Winston-Salem, NC 27101, United States of America.
The American Journal of Emergency Medicine
|October 4, 2021
Summary
Propylene glycol (PG) toxicity can occur from excessive ingestion, even from sources like corn starch. This condition leads to elevated lactic acid levels and can be fatal despite treatment.
Area of Science:
- Toxicology
- Internal Medicine
- Pharmacology
Background:
- Propylene glycol (PG) is generally recognized as safe but can cause toxicity with high doses or prolonged use.
- PG is commonly found in pharmaceuticals and food products.
- This case highlights potential toxicity from non-traditional PG sources.
Observation:
- A patient presented with altered mental status and metabolic acidosis after consuming large amounts of corn starch mixed with baking soda.
- Initial labs revealed hyponatremia, high anion gap metabolic acidosis, elevated creatinine, and high lactic acid levels.
- The patient's propylene glycol level was significantly elevated, indicating toxicity.
Findings:
- Propylene glycol is metabolized into lactic acid, contributing to toxicity.
- The patient underwent intermittent hemodialysis to clear propylene glycol and lactic acid.
- Despite treatment, the patient succumbed to complications during hospitalization.
Implications:
- Excessive ingestion of products containing propylene glycol can lead to severe toxicity.
- Healthcare providers should consider propylene glycol toxicity in patients with unexplained metabolic acidosis.
- Awareness of PG's metabolic pathway to lactic acid is crucial for diagnosis and management.
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