Venous diethylene glycol poisoning in patients with preexisting severe liver disease in China

Table 1 Basic information concerning patients receiving venous diethylene glycol injections (n = 64)

Item	DEG-poisoned group (n = 15)	Non-DEG-poisoned group (n = 49)	Statistical value	P value
Male sex (%)	14 (93.3)	35 (71.4)	3.071	0.080
Age (yr)
Median	50	48	1.11	0.267
Range	33-76	5-72
DEG intake-ml
Median	24	36	0.27	0.787
Range	9-72	2.4-114
DEG concentration (%)
Median	6	6	0.713	0.476
Range	3-6	1.2-6
Alcoholics (%)	7 (46.7)	19 (38.8)	0.296	0.586
Diagnosis			11.691	0.039
TLD (%)	12 (80.0)	21 (42.9)	6.344	0.012
CH (%)	2 (13.3)	19 (38.8)		0.1122
Other (%)	1 (6.7)	9 (18.4)		0.2582
Diuretics (%)	12 (80.0)	16 (32.7)		0.0202
Complication
Ascites (%)	10 (66.7)	9 (18.4)		0.000
Renal disease2 (%)	5 (33.3)	3 (6.1)		0.0141
Serum checking
ALT (U/L)	180.9 ± 269.9	201.4 ± 284.3	0.251	0.804
TB (&mgr;mol/L)	359.2 ± 245	239.3 ± 221.5	1.767	0.082
BUN (mmol/L)	7.9 ± 3.8	4.3 ± 2.9	3.372	0.003
Creatinine (&mgr;mol/L)	94.2 ± 24.6	58.7 ± 22.6	5.141	0.000
Ca2+ (mmol/L)	2.37 ± 0.17	2.25 ± 0.21	2.157	0.035
Phosphonium (mmol/L)	0.72 ± 0.43	1.00 ± 0.33	2.574	0.013
WBC (109/L)	6.47 ± 2.08	6.00 ± 5.34	0.326	0.746
NEUT	0.716 ± 0.114	0.587 ± 0.153	3.003	0.004
RBC (1012/L)	3.03 ± 0.92	3.33 ± 0.79	1.208	0.232
Hemoglobin (g/L)	99.9 ± 25.6	106.6 ± 18.8	1.035	0.305
Platelet count (109/L)	106.9 ± 50.6	125.9 ± 73.3	0.293	0.354

TLD: Terminal liver disease, including severe hepatitis, liver cirrhosis, recurrence of post liver transplantation; ALT: alanine aminotransferase; CH: Chronic hepatitis; TB: total bilirubin; WBC: White blood cells; RBC: Red blood cells; NEUT: Ratio of neutral leucocyte; BUN: Blood urea nitrogen.

¹Fisher's exact test;

²Pre-existing renal diseases, including kidney stones, proliferative renal cysts and urinary tract infections. One case of renal carcinoma was observed in the non-poisoned group.

Table 2 Clinical characteristics of 15 DEG-poisoned patients

Characteristics	Data
Age (yr)	50 (33-76)
Male sex (%)	14 (93.6)
Injected DEG volume (mL)	24 (9-72)
ARF (%)	15 (100)
Incubation period of ARF (d)	5 (2-12)
Incubation periods of anuria (d)	6 (3-13)
Fever (%)	7 (46.7)
Incubation periods (d)	6 (1-13)
Dig. tract symptoms (%)	11 (73.3)
Incubation period (d)	9 (3-19)
Nerv. syst. impair (%)	10 (66.7)
Incubation periods (d)	14 (7-24)
Cranial nerves (%)	10 (64.7)
Peripheral nerves (%)	5 (33.3)
Central nerv. syst. (%)	6 (40.0)
Metab. acidosis (n = 13) (%)	13 (100)
Incubation periods of abnormal Cr and/or BUN (d)	5 (2-12)
Time of peak Cr (d)	11 (6-19)
Time of peak BUN (d)	14 (6-23)
Incubation periods of abnormal CO2 (d)	9 (2-14)
Time of peak CO2 (d)	10 (5-16)
Death (%)	12 (80.0)
Death time after injection (d)	12.5 (8-65)
Causes of death (n = 12)
MODS (%)	7 (58.3)
Infection (%)	4 (33.3)
Dig. tract bleed (%)	1 (8.3)

Table 3 Liver-renal function measurements and peripheral blood cell counts before and after DEG poisoning

Item	n	BP	AP	t-value	P	CI
TB (&mgr;mol/L)	15	376.7 ± 244.6	354.7 ± 257.1	0.945	0.362	-28.36-72.44
PT (s)	15	24.4 ± 13.1	22.4 ± 8.8	1.33	0.210	-1.34-5.41
GGT (U/L)	14	163.2 ± 225.5	109.4 ± 115.8	1.451	0.170	-26.3-133.8
ALP (U/L)	14	217.0 ± 265.4	146.7 ± 148.8	1.888	0.082	10.2-150.7
BUN (mmol/L)	15	7.4 ± 3.9	31.2 ± 9.68	8.373	0.000	17.61-30.00
Cr (&mgr;mol/L)	15	94.2 ± 24.1	691.6 ± 197.8	10.659	0.000	475.28-719.51
CO2 (mmol/L)	13	24.4 ± 3.9	13.1 ± 2.6	11.75	0.000	9.20-13.39
Ca2+ (mmol/L)	14	2.38 ± 0.18	2.41 ± 0.22	-0.737	0.474	-0.13-0.07
Phosphonium (mmol/L)	14	0.73 ± 0.45	1.31 ± 0.50	-4.088	0.001	-0.90-(-0.28)
WBC (109/L)	15	6.59 ± 2.33	9.78 ± 3.75	3.325	0.008	1.05-5.33
RBC (1012/L)	15	2.99 ± 0.94	2.32 ± 0.76	2.968	0.014	0.16-1.17
Hb (g/L)	15	99.6 ± 25.1	79.5 ± 23.6	2.823	0.018	4.25-36.11
PLT (109/L)	15	119.6 ± 50.1	94.6 ± 72.6	1.336	0.211	-16.75-66.93

BP: The last values before DEG poisoning; AP: The peak values after DEG poisoning; GGT: Gamma-glutamyl transpeptidase; ALP: Alkaline phosphatase.