| Glue Sniffing Presenting with Severe Hypokalemia and Metabolic Acidosis: A Case Report |
| Sae Hoon Park, Hyuk Joong Choi, Seung Min Chun, Na Rae Ha, Song Lee Park, Gheun Ho Kim, Tai Ho Im |
1Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea erthim@hanyang.ac.kr
2Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. |
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| ABSTRACT |
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Toluene is an aromatic hydrocarbon found in glues, cements, and solvents. Chronic or acute exposure is known to cause acid-base and electrolyte disorders and to be toxic to both the nervous system and the hematopoietic system. The three major clinical presentations involve neuropsychiatric, gastrointestinal, and muscular disorders, whereas toluene intoxication is difficult to diagnose without a history of substance abuse, such as glue sniffing. We report the case of a 27-year-old women who presented with the three major clinical manifestations associated with profound hypokalemia (K+=1 mEq/L) and metabolic acidosis (pH=7.17) after prolonged glue sniffing. To make an early diagnosis, the emergency physician should consider toluene intoxication in patients presenting with altered mental status, hypokalemic muscular paralysis, and a history of glue sniffing. |
| Key words:
Toluene, Metabolic acidosis, Hypokalemia |
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