Skip to main content
SpringerLink
Log in

A case of suicide secondary to diethylene glycol intentional ingestion

  • Case Report
  • Published:
Forensic Science, Medicine and Pathology Aims and scope Submit manuscript

Abstract

We aimed to describe a case of acute kidney injury (AKI) with an uncommon case. We described a previously health 24 years old male that presented acute kidney injury associated with neurological and respiratory symptoms. He was initially admitted at the hospital with nausea, vomiting, blurred vision, and reduced urine output. The patient’s condition got worse approximately in one week. Laboratory tests revealed high levels of nitrogenous waste, hyponatremia, metabolic acidosis with an increased anion gap, and the presence of proteinuria and hematuria. The patient experienced paresthesia, seizures, respiratory alterations, and altered consciousness. The initial diagnostic hypothesis of rapidly progressive glomerulonephritis was not confirmed. A deeper investigation of the case exposed that it could have occurred an intentional exogenous poisoning with diethylene glycol (DEG). Renal biopsy unveil findings suggestive of poison-induced nephrotoxicity, which corroborated the suspicion. Despite therapeutic efforts, the patient died due to pulmonary complications. This case report shows the need to consider DEG poisoning as a etiology of AKI, especially in patients with neurological symptoms. Laboratory and histopathological analysis were crucial for the diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Gopalakrishnan N, Kamarajan M, Balasubramaniyan T, Sakthirajan R, Dhanapriya J, Dineshkumar T. Diethylene glycol poisoning-induced acute kidney injury. Saudi J Kidney Dis Transpl. 2016;27:1276–9. https://doi.org/10.4103/1319-2442.194692.

    Article  PubMed  Google Scholar 

  2. Rentz ED, Lewis L, Mujica OJ, Barr DB, Schier JG, Weerasekera G, et al. Outbreak of acute renal failure in Panama in 2006: a case-control study. Bull World Health Organ. 2008;86(10):749–56. https://doi.org/10.2471/blt.07.049965.

    Article  PubMed  PubMed Central  Google Scholar 

  3. de Almeida Araújo S, Faria BCD, Vasconcelos JC, da Cruz AF, de Souza VS, Wanderley DC, et al. Renal toxicity caused by diethylene glycol: an overview. Int Urol Nephrol. 2023;1–9. https://doi.org/10.1007/s11255-023-03604-2.

  4. Landry GM, Martin S, McMartin KE. Diglycolic acid is the nephrotoxic metabolite in diethylene glycol poisoning inducing necrosis in human proximal tubule cells in vitro. Toxicol Sci. 2011;124(1):35–44. https://doi.org/10.1093/toxsci/kfr204.

    Article  CAS  PubMed  Google Scholar 

  5. Schep LJ, Slaughter RJ, Temple WA, Beasley DMG. Diethylene glycol poisoning. Clin Toxicol. 2009;47(6):525–35. https://doi.org/10.1080/15563650903086444.

    Article  CAS  Google Scholar 

  6. Yang SY, Chiou TT, Shiao CC, Lin HY, Chan MJ, Wu CH, Sun CY, Wang WJ, Huang YT, Wu VC, Chen YC, Fang JT, Hwang SJ, Pan HC. Nomenclature and diagnostic criteria for acute kidney injury – 2020 consensus of the Taiwan AKI-task force. J Formos Med Assoc. 2022;121(4):749–65. https://doi.org/10.1016/j.jfma.2021.08.005.

    Article  PubMed  Google Scholar 

  7. Wittschieber D, Heuberger K, Schulz R, Köhler H, Varchmin-Schultheiß K. Fatal poisoning with diethylene glycol in an unusual setting. Forensic Sci Med Pathol. 2019;15:649–52. https://doi.org/10.1007/s12024-019-00123-4.

    Article  CAS  PubMed  Google Scholar 

  8. Morelle J, Kanaan N, Hantson P. The Case∣ cranial nerve palsy and acute renal failure after a ‘special drink’. Kidney Int. 2010;77(6):559–60. https://doi.org/10.1038/ki.2009.514.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Instituto de Nefropatologia, Belo Horizonte, MG, Brasil

    Stanley de Almeida Araújo, Isabela Stefanon & David Campos Wanderley

  2. Centro de Microscopia Eletrônica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil

    Stanley de Almeida Araújo & David Campos Wanderley

  3. Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 190, 2o andar, sala 281, Bairro Santa Efigênia, Belo Horizonte CEP, MG, 30130-100, Brasil

    Isabela Stefanon & Ana Cristina Simões-e-Silva

  4. Sociedade Hospitalar Angelina Caron, Campina Grande do Sul, Paraná, Brasil

    Rodrigo Zamprogna & Rafaele Zampier

Authors
  1. Stanley de Almeida Araújo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Isabela Stefanon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Campos Wanderley
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rodrigo Zamprogna
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rafaele Zampier
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ana Cristina Simões-e-Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ana Cristina Simões-e-Silva.

Ethics declarations

Ethical approval

The family of the patient gave signed authorization to report the case. The study of diethylene glycol poising was approved in the Ethics Committee of the Faculdade de Ciências Médicas de Minas Gerais (FCMMG) – Belo Horizonte, Minas Gerais, Brasil.

Conflict of interest

None declared.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Araújo, S.A., Stefanon, I., Wanderley, D.C. et al. A case of suicide secondary to diethylene glycol intentional ingestion. Forensic Sci Med Pathol (2024). https://doi.org/10.1007/s12024-024-00832-5

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12024-024-00832-5

Keywords

Search

Navigation