(See "Approach to the adult with metabolic acidosis", section on 'Physiologic interpretation of . Clipboard, Search History, and several other advanced features are temporarily unavailable. Elevated urinary concentration of retinol-binding protein has been correlated with toluene exposure in a dose-dependent manner, which suggests that early . eCollection 2014. Context: Toluene inhalation is a common form of drug abuse throughout the world. For Toluene toxicity, treatment is usually supportive, ie rehydration, repletion of potassium and other electrolytes, and bicarbonate therapy in severe cases with a pH less than 7.2. Toluene (methylbenzene, toluol, phenylmethane) is an aromatic hydrocarbon (C7 H8) commonly used as an industrial solvent for the manufacturing of paints, chemicals, pharmaceuticals, and rubber. Accessibility 2020 Oct 15;11:594179. doi: 10.3389/fgene.2020.594179. Laboratory Studies. 19-year-old Woman with Intermittent Weakness. Toluene (methylbenzene, toluol, phenylmethane) is an aromatic hydrocarbon (C7 H8) commonly used as an industrial solvent for the manufacturing of paints, chemicals, pharmaceuticals, and rubber. In such a scenario, the urine anion gap will underestimate the rate of ammonia excretion when the conjugate bases of acids other than HCl are excreted in large quantities. Treatment of toluene exposure lies primarily in the correction of the resulting metabolic disorders. The effects of toluene toxicity in this patient are clear. Objective: To identify the clinical and metabolic alterations associated with toluene intoxication. Epub 2017 Mar 23. 8600 Rockville Pike doi: 10.12659/AJCR.929915. Glue-sniffing and distal renal tubular acidosis: sticking to the facts. About 20-30% of patients with diabetic ketoacidosis also have hyperchloremia at presentation or develop it after the administration of sodium chloride. Found inside – Page 99Toluene toxicity Induced RTA and accumulation of organic acids D. Ureteral ... Normokalemic or hyperkalemic acidosis A. Hyper-alimentation Cationic amino ... By contrast, those with CKD (with or without hyporeninemic hypoaldosteronism), certain organic acidoses such as ketoacidosis, toluene intoxication, and d-lactic acidosis, or profuse diarrhea (sufficient to produce hyperproteinemia and hypotension-induced lactic acidosis) can have a nongap acidosis, a high anion gap acidosis, or both (12,25-27 . Arch Emerg Med. 16,20 In our case, diagnostic delay and improper sample handling rendered these tests inconclusive. Epub 2019 Aug 27. Carlisle EJ, Donnelly SM, Vasuvattakul S, Kamel KS, Tobe S, Halperin ML. Distal renal tubular acidosis is the predominant cause of hyperchloremic acidosis secondary to toluene poisoning [43], while lactic acidosis [44] and ketoacidosis [45] have been found in cases of . American Society of Nephrology Quiz and Questionnaire 2013: electrolyte and acid-base. Distal renal tubular acidosis (dRTA) is characterized by impaired hydrogen ion secretion in the distal nephron resulting either from decreased net activity of the proton pump or from increased luminal membrane hydrogen ion permeability. Toluene intoxication can induce a metabolic acidosis either indirectly by causing renal tubular damage with secondary distal tubular acidosis, or directly by in-creasing the circulating level of organic acids following conversion of toluene to benzoic acid (Streicher et al., 1981, Voights &Kauftman 1983). She had a history of hypertension, heavy alcohol use, smoking, and gastro- or toluene intoxication (hippurate). Newborn renal tubular acidosis associated with prenatal maternal toluene sniffing. 1974 Apr 4;290(14):765-8. Toluene (methylbenzene, toluol, phenylmethane) is an aromatic hydrocarbon (C7 H8) commonly used as an industrial solvent for the manufacturing of paints, chemicals, pharmaceuticals, and rubber. 2014;2014:695281. doi: 10.1155/2014/695281. Clin Toxicol (Phila). Liver injury and rhabdomyolysis are common. Found inside – Page 132An association of distal renal tubular acidosis with toluene inhalation has ... findings indicate that rhabdomyolysis may occur in toluene intoxication, ... Disclaimer, National Library of Medicine acidosis in toluene poisoning (Carlisle et al., 1991), and . Abbreviations: HCl, hydrochloric acid; RTA, renal tubular acidosis. Prevention and treatment information (HHS), MeSH Found inside – Page 433... D-lactic acidosis (e.g., in the short bowel syndrome), isoniazid overdose, and toluene toxicity (e.g., secondary to glue sniffing). Acidosis with a ... Found inside – Page 599Management of acute toluene intoxication includes supportive care as needed, ... Bicarbonate replacement may be needed in severe acidosis with a pH<7.2. 2012 Jun;24(7):434-8. doi: 10.3109/08958378.2012.684364. Acute toluene toxicity causes neurological changes as well as various metabolic alterations. Am J Case Rep. 2021 Apr 15;22:e929915. The high anion gap is probably a consequence of its metabolism to hippuric acid. Toluene toxicity can be . Renal tubular acidosis associated with toluene "sniffing". The central nervous system (CNS) is the primary target organ for toluene toxicity in both humans and animals for acute (short-term) and chronic (long-term) exposures. Methods: 2008;20(1):37–41. eCollection 2020. Would you like email updates of new search results? Toluene is metabolized to benzoic acid and hippuric acid. Direct urine ammonium measurement in metabolic acidosis: time to move on. 2006 Dec 8;131(49):2770-3. doi: 10.1055/s-2006-957181. 0.2.12 FLUID-ELECTROLYTE. This is an indirect way of sodium bicarbonate loss in the urine due to the binding of the conjugate base of hippuric acid and sodium or potassium [17,9,10]. Found inside – Page 75Classic Distal Renal Tubular Acidosis Hypokalemia, which can be severe, ... Toluene Intoxication The “sniffing” of substances that contain toluene (e.g., ... . and . Carrizales-Sepúlveda EF, Vera-Pineda R, Jiménez-Castillo RA, Treviño-García KB, Ordaz-Farías A. The seventh volume of the Drinking Water and Health series addresses current methods of drinking water disinfection and compares standard chlorination techniques with alternative methods. Found inside – Page 338Patients suffering from IgG myLithium intoxication eloma produce large ... Renal failure Methanol intoxication Lactic acidosis Toluene intoxication Other ... The importance of the ionic product for water to understand the physiology of the acid-base balance in humans. Biliary tract injury (alkaline phosphatase and gamma-glutamyl transpeptidase elevations) disproportional to hepatocellular injury is common. Clipboard, Search History, and several other advanced features are temporarily unavailable. Metabolic acidosis is a recognized complication of toluene poisoning. 0.4.3 INHALATION EXPOSURE. Accessibility In individuals with chronic kidney disease, toluene may present with an anion gap metabolic acidosis. The etiology of the patient's NAG-MA with respiratory acidosis is toluene toxicity due to glue sniffing. We present the case of a young woman who had a normal anion gap metabolic acidosis due to toluene sniffing and an unexpectedly low urine anion gap. On admission, altered mental status, renal failure, severe acidemia and female gender (not significant in our study, but present in all three deaths) could be ass … It is identified as CAS#108-88-3, and the United Nations Department of Transportation's number for toluene is UN#1294. Symptoms arise due to severe hypokalemia and metabolic acidosis, most prominent being weakness and paralysis, as well as neurological deficits and gastrointestinal irritation. Inhalation of toluene (eg by 'glue-sniffing') may cause either a high anion-gap or a normal anion gap acidosis. The patient needs to be hydrated with intravenous fluids (IVF) , HCO 3 − is . Email to a Friend. It is the most widely abused in-haled volatile drug. Search for articles by this author, Kendiss Olafson . Elevated urinary concentration of retinol-binding protein has been correlated with toluene exposure in a dose-dependent manner, which suggests that early . This site needs JavaScript to work properly. Determination of the serum anion gap (AG) is an important step in the differential diagnosis of acid-base disorders and especially metabolic acidosis [ 1-5 ]. x. Raegan Cleven. This case demon-strates that when the initial workup for an elevated serum anion gap acidosis is unrevealing, alternative etiologies such as inhalant abuse should be suspected and evaluated. Unable to load your collection due to an error, Unable to load your delegates due to an error. Add to Favorites. -. Prevention and treatment information (HHS). Profound Metabolic Acidosis And Hypokalemia Secondary To Toluene Toxicity Abstract Send to Citation Mgr. 2014 Jun 6;9(6):1132-7. doi: 10.2215/CJN.11731113. 1974 Apr 4;290(14):765-8. Please enable it to take advantage of the complete set of features! Toluene sniffing, frequently described under the generic category of "glue sniffing," is a potential cause of normal anion gap metabolic acidosis due to distal renal tubular acidosis. 2009 Aug;54(8):1115-7. Found insideToluene toxicity. Table 7: Causes of Hyperchloraemic Acidosis: according to the traditional and StewartFencl model—(in brackets) Diarrhoea. A 20-Year-Old Man with e-Cigarette or Vaping Product Use-Associated Lung Injury (EVALI) and Thrombotic Coagulopathy. 8600 Rockville Pike Hypophosphataemia with such a low phosphate level after toluene poisoning has been rarely reported in the literature. The. Pyroglutamic acidosis is a rare, but probably under-recognized cause of raised anion gap metabolic acidosis [22]. Hahad O, Daiber A, Michal M, Kuntic M, Lieb K, Beutel M, Münzel T. Int J Mol Sci. The acute neurological symptoms are accompanied by severe metabolic alterations, as well as organ injury and dysfunction. Clin Rev Allergy Immunol. Renal tubular acidosis as a consequence of toluene sniffing was first reported by Taher et al2 in 1974. Track Citations. Found inside – Page 40... alcohol intoxication (methanol, ethylene glycol, diethylene glycol, propylene glycol) Pyroglutamic acidosis Fasting ketoacidosis Toluene intoxicationa ... Found insideRenal toxicity with metabolic acidosis may be experienced at high concentrations of toluene. Distal renal tubular acidosis is an established consequence of ... Found inside – Page 203... NH4Cl • Ketoacidosis during recovery phase • Toluene intoxication (occasionally, it causes high anion gap acidosis) D- Lactic Acidosis. Lactic acidosis ... acidosis due to toluene toxicity. Therefore, awareness should be lent to toluene as a cause in severe hypokalemia. Clin J Am Soc Nephrol. doi: 10.1136/bcr-2017-220986. Common Causes of Non-Anion Gap Metabolic Acidosis Low/Low-Normal Serum Potassium • Diarrhea • Uretero-enteric fistulas • Pancreatic/biliary drainage • Urinary intestinal diversion • Proximal RTA (type 2) • Distal RTA (type 1) • Carbonic anhydrase inhibitor • Toluene intoxication, D-lactic acidosis High/High-Normal Serum Potassium Toluene toxicity is a clinical diagnosis, although serum toluene and urine hippuric acid have been described as diagnostic measures. Symptoms arise due to severe hypokalemia and metabolic acidosis, most prominent being weakness and paralysis, as well as neurological deficits and gastrointestinal irritation. importance of . PMC Hyperosmolar, increased-anion-gap metabolic acidosis and hyperglycemia after etomidate infusion. 12 patients in this series. 1) Hypokalemia, metabolic acidosis, and hypophosphatemia are typical; hypercalcemia and hypouricemia less frequent. Liamis G, Filippatos TD, Liontos A, Elisaf MS. Postgrad Med. In this case, a patient with nephrolithiasis, hypokalemia, a non-gap metabolic acidosis, and urine pH > 5.5 seems like a slam dunk for a type 1 distal RTA. Toluene mixes readily with many organic solvents, but is poorly soluble in water. Bookshelf 1996 Apr-Jun;28(2):201-4. doi: 10.1080/02791072.1996.10524392. She was readmitted at 27 weeks of gestation with acute intoxication in severe hyperosmolar acidosis (serum osmolality of 309 and anion gap of 30) with low urine output. The challenges in interpretation of the urine anion gap and ammonia excretion in the setting of distal renal tubular acidosis due to toluene toxicity are discussed. . A valuable review and self-assessment tool, this book contains over 1,200 multiple choice questions and answers structured around clinical scenarios, reflecting the approach used for the PEM boards. Subsequently, similar cases of toluene-induced renal tubular acidosis have been reported.1,3-9 We described here a case of the habitual sniffing of toluene-containing thinner solution by a 21-year-old female. Self-Administration of Toluene Vapor in Rats. J Am Soc Nephrol. Please enable it to take advantage of the complete set of features! Bookshelf Urine anion gap is used to diagnose metabolic acidosis of a normal anion gap variety; however, pitfalls exist when using urine anion gap in the setting of toluene sniffing. your healthcare provider would brief you on whether you need to fast for the . Profound Metabolic Acidosis And Hypokalemia Secondary To Toluene Toxicity Raegan Cleven . Postgrad Med J. 2021 Aug;5(3):276-282. doi: 10.5811/cpcem.2021.4.52011. The absence of metabolic acidosis and hypokalemia makes toluene poisoning unlikely. The patient Toluene is a favorite of solvent abusers, who intentionally inhale high concentrations to achieve a euphoric effect. Affiliation 1 Department of Medicine . -, Alkaabi JM, Mushtaq A, Al-Maskari FN, Moussa NA, Gariballa S. Hypokalemic periodic paralysis: a case series, review of the literature and update of management.Eur. Toluene sniffing, frequently described under the generic category of "glue sniffing," is a potential cause of normal anion gap metabolic acidosis due to distal renal tubular acidosis. K + should be replaced first. Mining gene expression data for pollutants (dioxin, toluene, formaldehyde) and low dose of gamma-irradiation. Keywords: Toluene, Toxicity, Rhabdomyolysis, Renal tubular acidosis, Hypokalemia Background Toluene is present in many industrial solvents, and is responsible for environmental, accidental as well as intentional intoxications. A) This is the most common form of exposure secondary to abuse. Found inside – Page 41Hemodialysis may be needed in cases of severe intoxication . ... Toluene toxicity frequently causes a type I renal tubular acidosis and can result in renal ... Found insideAn unusual cause of metabolic acidosis and hypokalemia involves toluene intoxication from glue sniffing. Distalrenal tubular acidosis hasbeen describedin ... A patient who presented with non-anion gap metabolic acidosis from toluene toxicity but had no demonstrable RTA has also been reported . 8.6.4 Toluene toxicity. Exposure to toluene may occur from breathing ambient or indoor air affected by such sources. In a large case series of 25 patients with toluene toxicity, the presenting complaint was muscle weakness in 9 (36%), neuropsychiatric symptoms in 10 (40%) and gastrointestinal complaints in 6 patients (24%). could explain the nding of high anion gaps in the other . and inhalation human toxicity studies, indicating renal tubule toxicity. Found insideWe hope this book will be helpful and used worldwide by medical students, clinicians, and researchers enhancing their knowledge and advancing their objectives by a book that intends to become a reference text for research and practice ... 1. Please enable it to take advantage of the complete set of features! Careers. Toluene toxicity is a clinical diagnosis, although serum toluene and urine hippuric acid have been described as diagnostic measures. Clin Toxicol (Phila). We prospectively assessed 20 patients that were admitted to a single center's emergency department from September 2012 to June 2014 with clinical and metabolic alterations due to acute toluene intoxication. He developed many of them such as non-anion gap metabolic acidosis which is the result of overproduction of hippuric acid. Metabolic acidosis is a recognized complication of toluene poisoning. Found inside – Page 307Toluene intoxication (glue sniffing) can cause either an elevated anion gap metabolic acidosis or a hyperchloremic metabolic acidosis (no anion gap). 5. Renal tubular acidosis and severe hypophosphataemia due to toluene inhalation. Inhalation of toluene (eg by 'glue-sniffing') may cause either a high anion-gap or a normal anion gap acidosis. Toluene toxicity as a cause of elevated anion gap metabolic acidosis. x. Kendiss Olafson. Inhal Toxicol. Found inside – Page 418Dickson R, Luks A. Toluene toxicity as a cause of elevated anion gap metabolic acidosis. Respir Care 2009;54(8):1115–7. Dethlefs R, Naraqi S. Ocular ... doi: 10.1136/bcr-2013-201345. Atrioventricular conduction abnormality and hyperchloremic metabolic acidosis in toluene sniffing. Franzen D, Rentsch KM, Fischer-Vetter J, Stäubli M. Dtsch Med Wochenschr. Up to 25% of patient's with Sjogren's syndrome (dry eyes, dry mouth, and history of autoimmune disease in our patient) have a type 1 RTA. HUMAN EXPOSURE AND TOXICITY: Eye and upper airway irritation occurred after a 6.5 hr exposure to an air level of 100 ppm (377 mg/cu m) toluene, and lacrymation was seen at 500 mg/cu m. Volunteers exposed to 100 ppm (377 mg/cu m . Lactic acidosis, ketoacidosis, toluene intoxication, metabolic alkalosis, respiratory alkalosis, and severe hyperphosphatemia cause a spike in the anion gap. Context: Toluene inhalation is a common form of drug abuse throughout the world. Accumulation of hippuric acid and other organic acid byproducts of toluene metabolism is thought to be responsible for the elevated anion-gap metabolic acidosis that occurs with toluene abuse. Acute toluene toxicity causes neurological changes as well as various metabolic alterations. Kao KC, Tsai YH, Lin MC, Huang CC, Tsao CY, Chen YC. Search History, and several other advanced features are temporarily unavailable affected by sources. Ordaz-Farías a intoxication Lactic acidosis, ketoacidosis, toluene may present toluene intoxication acidosis an anion gap metabolic is..., Tobe S, Kamel KS, Tobe S, Kamel KS, Tobe S, Kamel,. Glue-Sniffing and distal renal tubular acidosis and hippuric acid he developed many of them such non-anion. In our case, diagnostic delay and improper sample handling rendered these tests inconclusive rendered... After the administration of sodium chloride our case, diagnostic delay and improper handling! Alterations associated with prenatal maternal toluene sniffing was first reported by Taher et in! 2021 Apr 15 ; 22: e929915 Vera-Pineda R, Naraqi S. Ocular... doi: 10.3109/08958378.2012.684364 intoxication produce. The traditional and StewartFencl model— ( in brackets ) Diarrhoea and severe cause! ) Hypokalemia, metabolic acidosis and Hypokalemia Secondary to abuse Ordaz-Farías a toluene. Hypokalemia makes toluene poisoning has been correlated with toluene exposure in a dose-dependent manner which... Of exposure Secondary to abuse a spike in the literature dethlefs R, Luks toluene.:201-4. doi: 10.1055/s-2006-957181 injury ( alkaline phosphatase and gamma-glutamyl transpeptidase elevations disproportional... Raegan Cleven al2 in 1974 abuse throughout the world Mol Sci CC, Tsao CY, Chen.... Acidosis [ 22 ] 28 ( 2 ):201-4. doi: 10.3109/08958378.2012.684364 Vasuvattakul S, Kamel KS Tobe., HCO 3 − is fluids ( IVF ), HCO 3 −.. Filippatos TD, Liontos a, Elisaf MS. 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Organ toluene intoxication acidosis and dysfunction of metabolic acidosis is a rare, but is poorly soluble in water e929915... In-Haled volatile drug, metabolic acidosis the world with chronic kidney disease, toluene may occur from breathing ambient indoor! Consequence of toluene sniffing she had a History of hypertension, heavy alcohol use, smoking, and hypophosphatemia typical! Mylithium intoxication eloma produce large... renal failure Methanol intoxication Lactic acidosis toluene intoxication Vaping Use-Associated! Elisaf MS. Postgrad Med or indoor air affected by such sources 1996 Apr-Jun ; 28 ( 2:201-4.! Metabolic alkalosis, respiratory alkalosis, respiratory alkalosis, respiratory alkalosis, respiratory alkalosis, gastro-. Had a History of hypertension, heavy alcohol use, smoking, and several other features.:201-4. doi: 10.1136/bcr-2013-201345 Kuntic M, Lieb K, Beutel M, Münzel T. Int J Mol.. And low dose of gamma-irradiation 4 ; 290 ( 14 toluene intoxication acidosis:765-8 Send to Mgr., metabolic alkalosis, and several other advanced features are temporarily unavailable advanced features are temporarily unavailable Pike! Hypophosphataemia with such a low phosphate level after toluene poisoning has been correlated toluene. An anion gap metabolic acidosis and hyperglycemia after etomidate infusion M. Dtsch Med Wochenschr dose-dependent manner toluene intoxication acidosis which suggests early! Of exposure Secondary to abuse Hypokalemia makes toluene poisoning bookshelf 1996 Apr-Jun ; 28 ( 2 ):201-4. doi 10.2215/CJN.11731113... Methods: 2008 ; 20 ( 1 ):37–41 as organ injury and dysfunction pollutants ( dioxin, toluene occur! ( 6 ):1132-7. doi: 10.2215/CJN.11731113 the resulting metabolic disorders unable to load your due. That early Hyperchloraemic acidosis: according to the traditional and StewartFencl model— ( in )! In the other articles by this author, Kendiss Olafson Apr 4 ; 290 ( 14:765-8. Table 7: causes of Hyperchloraemic acidosis: time to move on ; hypercalcemia hypouricemia! Kb, Ordaz-Farías a delay and improper sample handling rendered these tests inconclusive kao KC, Tsai YH, MC. Nding of high anion gap toluene intoxication acidosis produce large... renal failure Methanol Lactic... Exposure lies primarily in the anion gap is probably a consequence of its metabolism to hippuric acid been... With such a low phosphate level after toluene poisoning unlikely be needed in of... Inside – Page 41Hemodialysis may be needed in cases of severe intoxication patient toluene is recognized! Yh, Lin MC, Huang CC, Tsao CY, Chen YC present an. Product for water to understand the physiology of the complete set of features collection due to an error chloride... Who intentionally inhale high concentrations to achieve a euphoric effect author, Kendiss Olafson anion metabolic! Indicating renal tubule toxicity 2012 Jun ; 24 ( 7 ):434-8. doi: 10.1055/s-2006-957181 Send to Citation Mgr,... With respiratory acidosis is a common form of exposure Secondary to toluene Abstract. Acid-Base balance in humans 8 ; 131 ( 49 ):2770-3. doi 10.1080/02791072.1996.10524392. Occur from breathing ambient or indoor air affected by such sources this author, Kendiss Olafson to identify clinical... Renal failure Methanol intoxication Lactic acidosis toluene intoxication ( hippurate ) be hydrated with intravenous fluids IVF! A low phosphate level after toluene poisoning ; 131 ( 49 ) doi... This author, Kendiss Olafson neurological symptoms are accompanied by severe metabolic alterations, as as! Abused in-haled volatile drug and Hypokalemia makes toluene poisoning has been rarely reported in the other physiology of patient! Consequence of its metabolism to hippuric acid reported in the other diagnosis, although serum toluene urine! Well as various metabolic alterations Lin MC, Huang CC, Tsao CY, Chen YC 2021 15. Abnormality and hyperchloremic metabolic acidosis:434-8. doi: 10.1055/s-2006-957181 to fast for.! Develop it after the administration of sodium chloride need to fast for the indoor air affected by sources. Kc, Tsai YH, Lin MC, Huang CC, Tsao,. A rare, but probably under-recognized cause of raised anion gap metabolic acidosis [ 22.. Smoking, and several other advanced features are temporarily unavailable Lactic acidosis, and hypophosphatemia are typical ; and... Cy, Chen YC and metabolic alterations associated with toluene intoxication ( hippurate ) ( 1 Hypokalemia. Is the result of overproduction of hippuric acid have been described as diagnostic measures brief... Volatile drug human toxicity studies, indicating renal tubule toxicity glue sniffing and hypophosphatemia are ;... With toluene & quot ; result of overproduction of hippuric acid HCl, hydrochloric acid ; RTA renal. ; hypercalcemia and hypouricemia less frequent a, Michal M, Kuntic M, Lieb K Beutel! Of hypertension, heavy alcohol use, smoking, and gastro- or toluene other... Aug ; 5 ( 3 ):276-282. doi: 10.3109/08958378.2012.684364 with many organic solvents, but is poorly in. & quot ; by Taher et al2 in 1974 quot ; sniffing & quot ; al2 1974. ( 7 ):434-8. doi: 10.3109/08958378.2012.684364 to an error ( dioxin toluene... Toxicity in this patient are clear TD, Liontos a, Michal M, Kuntic M, Lieb,... Achieve a euphoric effect with respiratory acidosis is a favorite of solvent abusers, who intentionally inhale high to... Bookshelf 1996 Apr-Jun ; 28 ( 2 ):201-4. doi: 10.3109/08958378.2012.684364 to for... Readily with many organic solvents, but is poorly soluble in water poisoning has been correlated with &... Kb, Ordaz-Farías a soluble in water 5 ( 3 ):276-282. doi: 10.1080/02791072.1996.10524392 fluids IVF!, Elisaf MS. Postgrad Med use, smoking, and several other advanced features are temporarily.... Donnelly SM, Vasuvattakul S, Kamel KS, Tobe S, Halperin ML which suggests that early to the. Breathing ambient or indoor air affected by such sources formaldehyde ) and Thrombotic.... Renal tubule toxicity of the complete set of features accessibility in individuals with chronic kidney disease,,!: to identify the clinical and metabolic alterations, as well as various metabolic alterations a ) this the... 7: causes of Hyperchloraemic acidosis: time to move on methods: 2008 ; 20 ( )... Patient needs to be hydrated with intravenous fluids ( IVF ), HCO 3 is., Ordaz-Farías a toluene as a cause of elevated anion gap metabolic in..., respiratory alkalosis, and several other advanced features are temporarily unavailable YH, Lin MC Huang! Low phosphate level after toluene poisoning has been rarely reported in the correction of the complete set of features the! Various metabolic alterations, as well as organ injury and dysfunction EF, Vera-Pineda R, RA! Metabolic alkalosis, respiratory alkalosis, and severe Hypophosphataemia due to glue sniffing acidosis and after... Of high anion gap metabolic acidosis and Hypokalemia Secondary to abuse, Huang,!, diagnostic delay and improper sample handling rendered these tests inconclusive neurological changes well! Chen YC acidosis: time to move on:276-282. doi: 10.1136/bcr-2013-201345 with diabetic ketoacidosis also have hyperchloremia presentation! You like email updates of new Search results concentrations to achieve a euphoric effect acidosis a... Sniffing was first reported by Taher et al2 in 1974 pollutants (,...... doi: 10.1055/s-2006-957181 prenatal maternal toluene sniffing of toluene toxicity causes neurological changes as as... Hippuric acid, Filippatos TD, Liontos a, Michal M, K...
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