Emerging progressive atypical acute kidney injury in young children linked to ethylene glycol and diethylene glycol intoxication

被引：2

作者：

Hidayati, Eka Laksmi ^{[1
]}

Fahlevi, Reza ^{[1
]}

Puspitasari, Henny Adriani ^{[1
]}

Tartila ^{[1
]}

Puspaningtyas, Niken Wahyu ^{[1
]}

Primacakti, Fitri ^{[1
]}

Saraswati, Meilania ^{[2
]}

Miranda, Monik Ediana ^{[2
]}

Prawira, Yogi ^{[1
]}

Prayitno, Ari ^{[1
]}

Pardede, Sudung Oloan ^{[1
]}

Putri, Nina Dwi ^{[1
]}

机构：

[1] Univ Indonesia, Cipto Mangunkusumo Hosp, Fac Med, Dept Child Hlth, Jakarta, Indonesia

[2] Univ Indonesia, Fac Med, Cipto Mangunkusumo Hosp, Dept Pathol Anat, Jakarta, Indonesia

来源：

PEDIATRIC NEPHROLOGY | 2024年 / 39卷 / 03期

关键词：

Acute kidney injury; Diethylene glycol; Ethylene glycol; Pediatric; ACUTE-RENAL-FAILURE; METABOLIC-ACIDOSIS; AKI; METHANOL;

D O I：

10.1007/s00467-023-06157-9

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

BackgroundThere had been a sudden surge of unusually severe and rapidly progressing acute kidney injury (AKI) incidence in Indonesia since August 2022 which did not correspond to the rise of COVID-19 incidence. We suspected this was related to ethylene glycol (EG) and diethylene glycol (DEG) intoxication. This study is aimed at describing the clinical and laboratory characteristics of AKI related to D(EG) intoxication in order to spread awareness of the possibility of intoxication in cases of rapidly progressing AKI with unknown etiology.MethodsWe conducted a cross-sectional study by collecting secondary data from the pediatric AKI registry at a national referral hospital in Jakarta, Indonesia. Data on children admitted from January to November 2022 with diagnosis of stage 3 AKI based on KDIGO criteria were included. Data regarding demographics, symptoms prior to anuria, laboratory results, infection panel including COVID-19 status, treatment administered, and mortality were analyzed.ResultsSixteen patients tested positive for EG and DEG, all with history of consuming syrup-based medications. High anion gap metabolic acidosis was observed in majority of patients with mean pH 7.33 +/- 0.07 and mean anion gap 15.6 +/- 7.8 mEq/L. No patient had high osmolal gap (mean osmolal gap 3.46 +/- 4.68). One deceased patient, who had kidney biopsy performed, showed severe damage and calcium oxalate crystals in the kidney tissue. Mortality was recorded in six patients (37.5%).ConclusionCareful history taking of patient's clinical course, including consumption of syrup-based medications and laboratory findings, might aid clinicians to establish a working diagnosis of D(EG) intoxication without needing to wait for blood toxicology test. Early diagnosis and therapy are crucial to prevent substantial mortality.Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information

引用

页码：897 / 904

页数：8

共 23 条

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