SOFT 2004 Meeting Abstracts - Society of Forensic Toxicologists

C26
CORRELATION BETWEEN METABOLIC ACIDOSIS AND CLINICAL PARAMETERS IN
DIETHYLENE GLYCOL (DEG) POISONING VICTIMS
L.A.Ferrari*! ,L. Giannuzzi 2
ILaboratory of Toxicology and Legal Chemistry, Buenos Aires Court of Justice. 41 y 119, (1900) La Plata,
Argentina. laferrari@unimoron.edu.ar
2Catedra de Toxicologla y Qulmica Legal. Facultad de Ciencias Exactas. Universidad Nacional de La Plata,
47 y 115 (1900). Argentina.leda@biol.unlp.edu.ar
This work analyzes fifteen victims of a massive intoxication that took place in Argentina in 1992 as a result
of the intake of pro polis syrup: a popular medicinal agent used in the 90s for upper respiratory system
infections. Diethylene glycol (DEG) was found as the responsible agent which caused metabolic acidosis,
anuria, renal failure and death in the 15 studied victims.
DEG poisoning cases were classified into three groups according to the survival time of the victims,
namely: 1) those who survived up to 3 days; 2) those who survived from 3 to 5 days; and 3) those who
survived from 5 to 21 days.
A methanolic fraction extracted in a Soxhlet system with subsequent concentration and purification was
obtained from viscera and blood. Gas Chromatography and FlO detector (GClFlO) methodology was
performed. On the other hand, samples of the propolis syrup from each of the victims was studied through
NMR and quantified by GClFlO, using ethylene glycol as internal standard. Finally, each clinical history
from victims were studied in detail: anionic Gap (AG), Excess base (EB) and pH.
Patients belonging to group 1 showed the highest AG values and the lowest (EB) values as well as the
major severity in their clinical manifestations. Correlation between pH and EB was ~ =0.68, 0.99 and 0.55
for groups 1,2 and 3 respectively. In 3 out of 15 fatal cases studied, DEG could be isolated from viscera
and blood. The concentration ratio (DEG)viscer.l (DEG)blood ranged 1.45 - 1.55 with a coefficient correlation
of ~ = 0.96. In the other victims, DEG could not be detected. This could be due to the long survival period
of the deceased victims from the syrup ingestion to death, and to the fact that putrefYing mechanisms could
be operating.
Results showed that the syrup samples contained DEG in a 24% to 65.0% (p/v) range. A proper correlation
between the amount ofDEG ingested and the anionic Gap (r2=0.63-0.78) could be observed in the victims
studied, according to theoretic amount of syrup ingestion (5 -20 ml). So, the lethal dose for humans in this
episode was found to vary from 0.019 to O.l74mg DEGlKg corporal weight. These results could contribute
to the understanding of DEG toxicity parameters On the other hand, they could provide data concerning
lethal dose in humans.
Keywords: Diethylene Glycol, poisoning, lethal dose
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