Toxic acute hepatitis and renal failure related to glue sniffing: a case report

Glue sniffing is the most prevalent form of inhalant abuse worldwide, especially prominent in developing countries. Toluene, a solvent in glue, is identified as its primary toxic component. Chronic abuse leads to symptoms like muscle weakness, gastrointestinal problems, and central nervous system impairment. Acute complications such as kidney injury and hepatitis with cholestasis are rare but severe. This report details a 19-year-old male who presented with abdominal pain, respiratory distress, and hemoptysis after glue inhalation. He rapidly developed renal failure and hepatic damage. Renal biopsy confirmed acute tubular epithelial injury. Hemodialysis was initiated due to severe toxicity, with complete recovery of renal and hepatic functions achieved within 25 days. These findings underscore the need to consider toluene inhalation in the differential diagnosis of acute renal failure, especially in young individuals. Additionally, a brief review of the literature highlights the acute renal and hepatic toxicities associated with toluene abuse.