Diethylene glycol is a common industrial
solvent which is responsible for accidental and epidemic
poisoning as early as the 1930s. Due to the unavailability and unaffordability of
ethanol, people in Qatar among the low income group are consuming household chemicals, some of which contain
diethylene glycol, for recreational purposes.The history of ingestion is usually not volunteered and the initial clinical presentation is usually nonspecific, making it difficult to diagnose from the clinical presentation. Moreover, the biochemical profile varies with time, making the diagnosis more difficult. The neurological course and toxicity is less well characterized than its renal counterpart. Moreover, reports in the literature of such recreational
poisoning is lacking particularly in the region.Three cases of recreational
diethylene glycol poisoning seen in Hamad General Hospital, Doha, Qatar from 2009 to 2012 are detailed here.These illustrate the
clinical course with emphasis on the neurological sequelae that include
encephalopathy and multiple cranial and
peripheral neuropathies with fatal and near-fatal outcomes. Neuroimaging in 2 were initially normal, but follow-up imaging showed brain
atrophy. The third patient's neuroimaging showed diffuse
brain edema with evidence of transtentorial herniation. Nerve conduction studies were performed in 2 of the 3 cases and showed evidence of mixed sensorimotor neuropathy. The outcomes were death in 1 and severe neurological morbidity and disability in 2 cases.Diethylene glycol is a dangerous substance when ingested and can result in mortality and severe morbidity, particularly from the renal and
neurological manifestations. Whereas the mechanism of damage is less well known, the damage is likely dose related. The typical clinical pattern of evolution of the
poisoning in the absence of cost-effective ways to detect it in the serum can help clinicians in making the diagnosis.Neurological manifestations may include
encephalopathy and multiple cranial and
peripheral neuropathies with subsequent brain
atrophy. Public awareness of the danger of such recreational use should be raised.