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Hypoglycemia following ethanol ingestion in children: report of a case
1Department of Medicine, Veterans General Hospital, Taipei, Taiwan, ROC.
Insights
Accidental ethanol ingestion in children can cause severe hypoglycemia. Prompt treatment with intravenous glucose is crucial for recovery and preventing serious complications.
Area of Science:
- Pediatrics
- Toxicology
- Biochemistry
Background:
- Ethanol is a common ingredient in household products and beverages, posing a risk of accidental ingestion by children.
- Ethanol ingestion in children can lead to serious metabolic and neurological issues, including hypoglycemia, acidosis, seizures, and coma.
- Limited data exists in Taiwan regarding the effects of ethanol ingestion on pediatric populations.
Observation:
- A case report details a 5-year-old boy who developed severe hypoglycemia and coma after ingesting rice wine.
- The child presented with extremely low plasma glucose and hypokalemia, with a blood ethanol level of 159 mg/dL three hours post-ingestion.
- Rapid recovery of consciousness was observed within 30 minutes following slow intravenous administration of 5% dextrose.
Findings:
- Ethanol-induced hypoglycemia in children can be easily missed due to the absence of typical adrenaline-related symptoms.
- Intravenous glucose administration is an essential and potentially life-saving treatment for ethanol-induced hypoglycemia.
- This case highlights the critical need for pediatricians to recognize and manage ethanol intoxication in children.
Implications:
- Pediatric healthcare providers must be aware of the severe consequences of ethanol ingestion in children.
- Implementing preventive strategies, such as child-resistant packaging and parental education, is vital to reduce the incidence of ethanol intoxication.
- Early diagnosis and prompt glucose treatment are paramount for favorable outcomes in pediatric ethanol poisoning cases.
Abstract:
Ethanol is present in a large number of pharmaceuticals, cosmetics, detergents and beverages. Without adequate safety measures, the accidental ingestion of such products by children is possible. Ethanol ingestion by children is known to cause various metabolic and neurologic disorders, including hypoglycemia, metabolic acidosis, seizures or coma. In Taiwan, little information has been published regarding the effects of ethanol ingestion by children. This is a report of a 5-year-old boy who became hypoglycemic after ingestion of rice wine. Admitted in a coma, the boy regained consciousness within 30 min after slow administration of 5% dextrose. His initial plasma glucose level was extremely low and hypokalemia was also found. Blood ethanol was 159 mg/dL, 3 h after the alcohol ingestion. He was discharged in good health the following day. Ethanol-induced hypoglycemia may be easily overlooked as symptoms of adrenaline excess are frequently absent. Prompt recognition and treatment with intravenous glucose are essential and may be life-saving. Pediatricians need to be aware of the devastating impact of ethanol. Preventive measures, such as child-proof packaging and parent education, are required if ethanol intoxication in children is to be avoided.