Clinical parameters, postmortem analysis and estimation of lethal dose in victims of a massive intoxication with diethylene glycol

Autores
Ferrari, Luis Alberto; Giannuzzi, Leda
Año de publicación
2005
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
This work analyzes a massive intoxication that occurred in 1992 in Argentina as a result of the use of propolis syrup as a popular upper respiratory infection medicinal agent. The intoxicating agent was diethylene glycol (DEG), which caused metabolic acidosis, anuria, renal failure and death in 15 out of the 29 studied victims. DEG poisoning cases were classified in three groups according to survival time: Group 1?patients that survived up to 3 days; Group 2?patients that survived between 4 and 5 days; Group 3?patients that survived between 6 and 21 days. Patients from Group 1 showed the highest values of anion gap, the lowest measures of base excess (BE) and more severe clinical manifestations. Correlation between pH and BE was r2 = 0.68, 0.99 and 0.55 for Groups 1, 2 and 3, respectively. A methanolic extraction was performed on the fatal victims? viscera and blood, with subsequent concentration and purification. The semi-crystalline fraction obtained retained DEG by means of codissolution and adsorption as demonstrated by thin lay chromatography/flame ionisation detection (TLC/FID). In 3 out of the 15 fatal cases (from Group 1), DEG was isolated from viscera and blood (femoral venous), between 48 and 72 h post ingestion. The concentration relation (DEG)viscera/(DEG)blood ranged from 1.45 to 1.55 with a coefficient correlation r2 = 0.96 (n = 3). In the other victims, DEG could not be detected. The reason for this could be the long survival period of the victims after their ingestion of the syrup. Additionally, putrefying mechanisms could have been operating. Samples of the propolis syrup of each victim were studied by means of nuclear magnetic resonance (NMR) and quantified by gas chromatography/flame ionisation detection (GC/FID). Results showed that syrup samples contained 65.0% (w/v) of diethylene glycol (DEG) and 32.0% (w/v) of propylene glycol (PG). A good correlation between the amount of DEG ingested and the anion gap (r2 = 0.63) for the 15 victims studied could be observed. The lethal dose for human beings estimated in this work ranged from 0.014 to 0.170 mg DEG/kg body weight. This is a lower lethal dose than reported in a separate incident in Haiti. These results may contribute to the understanding of DEG?s metabolic pathway and provides data from lethal doses in humans.
Fil: Ferrari, Luis Alberto. Universidad de Morón. Facultad de Ciencias Exactas, Químicas y Naturales; Argentina
Fil: Giannuzzi, Leda. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos; Argentina
Materia
DIETHYLENE GLYCOL
POSTMORTEM TISSUE
CLINICAL PARAMETERS
PROPOLIS SYRUP
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/158796

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oai_identifier_str oai:ri.conicet.gov.ar:11336/158796
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network_name_str CONICET Digital (CONICET)
spelling Clinical parameters, postmortem analysis and estimation of lethal dose in victims of a massive intoxication with diethylene glycolFerrari, Luis AlbertoGiannuzzi, LedaDIETHYLENE GLYCOLPOSTMORTEM TISSUECLINICAL PARAMETERSPROPOLIS SYRUPhttps://purl.org/becyt/ford/2.11https://purl.org/becyt/ford/2This work analyzes a massive intoxication that occurred in 1992 in Argentina as a result of the use of propolis syrup as a popular upper respiratory infection medicinal agent. The intoxicating agent was diethylene glycol (DEG), which caused metabolic acidosis, anuria, renal failure and death in 15 out of the 29 studied victims. DEG poisoning cases were classified in three groups according to survival time: Group 1?patients that survived up to 3 days; Group 2?patients that survived between 4 and 5 days; Group 3?patients that survived between 6 and 21 days. Patients from Group 1 showed the highest values of anion gap, the lowest measures of base excess (BE) and more severe clinical manifestations. Correlation between pH and BE was r2 = 0.68, 0.99 and 0.55 for Groups 1, 2 and 3, respectively. A methanolic extraction was performed on the fatal victims? viscera and blood, with subsequent concentration and purification. The semi-crystalline fraction obtained retained DEG by means of codissolution and adsorption as demonstrated by thin lay chromatography/flame ionisation detection (TLC/FID). In 3 out of the 15 fatal cases (from Group 1), DEG was isolated from viscera and blood (femoral venous), between 48 and 72 h post ingestion. The concentration relation (DEG)viscera/(DEG)blood ranged from 1.45 to 1.55 with a coefficient correlation r2 = 0.96 (n = 3). In the other victims, DEG could not be detected. The reason for this could be the long survival period of the victims after their ingestion of the syrup. Additionally, putrefying mechanisms could have been operating. Samples of the propolis syrup of each victim were studied by means of nuclear magnetic resonance (NMR) and quantified by gas chromatography/flame ionisation detection (GC/FID). Results showed that syrup samples contained 65.0% (w/v) of diethylene glycol (DEG) and 32.0% (w/v) of propylene glycol (PG). A good correlation between the amount of DEG ingested and the anion gap (r2 = 0.63) for the 15 victims studied could be observed. The lethal dose for human beings estimated in this work ranged from 0.014 to 0.170 mg DEG/kg body weight. This is a lower lethal dose than reported in a separate incident in Haiti. These results may contribute to the understanding of DEG?s metabolic pathway and provides data from lethal doses in humans.Fil: Ferrari, Luis Alberto. Universidad de Morón. Facultad de Ciencias Exactas, Químicas y Naturales; ArgentinaFil: Giannuzzi, Leda. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos; ArgentinaElsevier Ireland2005-10info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/158796Ferrari, Luis Alberto; Giannuzzi, Leda; Clinical parameters, postmortem analysis and estimation of lethal dose in victims of a massive intoxication with diethylene glycol; Elsevier Ireland; Forensic Science International; 153; 1; 10-2005; 45-510379-07381872-6283CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://www.sciencedirect.com/science/article/abs/pii/S0379073805002070info:eu-repo/semantics/altIdentifier/doi/10.1016/j.forsciint.2005.04.038info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:45:00Zoai:ri.conicet.gov.ar:11336/158796instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:45:00.987CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Clinical parameters, postmortem analysis and estimation of lethal dose in victims of a massive intoxication with diethylene glycol
title Clinical parameters, postmortem analysis and estimation of lethal dose in victims of a massive intoxication with diethylene glycol
spellingShingle Clinical parameters, postmortem analysis and estimation of lethal dose in victims of a massive intoxication with diethylene glycol
Ferrari, Luis Alberto
DIETHYLENE GLYCOL
POSTMORTEM TISSUE
CLINICAL PARAMETERS
PROPOLIS SYRUP
title_short Clinical parameters, postmortem analysis and estimation of lethal dose in victims of a massive intoxication with diethylene glycol
title_full Clinical parameters, postmortem analysis and estimation of lethal dose in victims of a massive intoxication with diethylene glycol
title_fullStr Clinical parameters, postmortem analysis and estimation of lethal dose in victims of a massive intoxication with diethylene glycol
title_full_unstemmed Clinical parameters, postmortem analysis and estimation of lethal dose in victims of a massive intoxication with diethylene glycol
title_sort Clinical parameters, postmortem analysis and estimation of lethal dose in victims of a massive intoxication with diethylene glycol
dc.creator.none.fl_str_mv Ferrari, Luis Alberto
Giannuzzi, Leda
author Ferrari, Luis Alberto
author_facet Ferrari, Luis Alberto
Giannuzzi, Leda
author_role author
author2 Giannuzzi, Leda
author2_role author
dc.subject.none.fl_str_mv DIETHYLENE GLYCOL
POSTMORTEM TISSUE
CLINICAL PARAMETERS
PROPOLIS SYRUP
topic DIETHYLENE GLYCOL
POSTMORTEM TISSUE
CLINICAL PARAMETERS
PROPOLIS SYRUP
purl_subject.fl_str_mv https://purl.org/becyt/ford/2.11
https://purl.org/becyt/ford/2
dc.description.none.fl_txt_mv This work analyzes a massive intoxication that occurred in 1992 in Argentina as a result of the use of propolis syrup as a popular upper respiratory infection medicinal agent. The intoxicating agent was diethylene glycol (DEG), which caused metabolic acidosis, anuria, renal failure and death in 15 out of the 29 studied victims. DEG poisoning cases were classified in three groups according to survival time: Group 1?patients that survived up to 3 days; Group 2?patients that survived between 4 and 5 days; Group 3?patients that survived between 6 and 21 days. Patients from Group 1 showed the highest values of anion gap, the lowest measures of base excess (BE) and more severe clinical manifestations. Correlation between pH and BE was r2 = 0.68, 0.99 and 0.55 for Groups 1, 2 and 3, respectively. A methanolic extraction was performed on the fatal victims? viscera and blood, with subsequent concentration and purification. The semi-crystalline fraction obtained retained DEG by means of codissolution and adsorption as demonstrated by thin lay chromatography/flame ionisation detection (TLC/FID). In 3 out of the 15 fatal cases (from Group 1), DEG was isolated from viscera and blood (femoral venous), between 48 and 72 h post ingestion. The concentration relation (DEG)viscera/(DEG)blood ranged from 1.45 to 1.55 with a coefficient correlation r2 = 0.96 (n = 3). In the other victims, DEG could not be detected. The reason for this could be the long survival period of the victims after their ingestion of the syrup. Additionally, putrefying mechanisms could have been operating. Samples of the propolis syrup of each victim were studied by means of nuclear magnetic resonance (NMR) and quantified by gas chromatography/flame ionisation detection (GC/FID). Results showed that syrup samples contained 65.0% (w/v) of diethylene glycol (DEG) and 32.0% (w/v) of propylene glycol (PG). A good correlation between the amount of DEG ingested and the anion gap (r2 = 0.63) for the 15 victims studied could be observed. The lethal dose for human beings estimated in this work ranged from 0.014 to 0.170 mg DEG/kg body weight. This is a lower lethal dose than reported in a separate incident in Haiti. These results may contribute to the understanding of DEG?s metabolic pathway and provides data from lethal doses in humans.
Fil: Ferrari, Luis Alberto. Universidad de Morón. Facultad de Ciencias Exactas, Químicas y Naturales; Argentina
Fil: Giannuzzi, Leda. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos; Argentina
description This work analyzes a massive intoxication that occurred in 1992 in Argentina as a result of the use of propolis syrup as a popular upper respiratory infection medicinal agent. The intoxicating agent was diethylene glycol (DEG), which caused metabolic acidosis, anuria, renal failure and death in 15 out of the 29 studied victims. DEG poisoning cases were classified in three groups according to survival time: Group 1?patients that survived up to 3 days; Group 2?patients that survived between 4 and 5 days; Group 3?patients that survived between 6 and 21 days. Patients from Group 1 showed the highest values of anion gap, the lowest measures of base excess (BE) and more severe clinical manifestations. Correlation between pH and BE was r2 = 0.68, 0.99 and 0.55 for Groups 1, 2 and 3, respectively. A methanolic extraction was performed on the fatal victims? viscera and blood, with subsequent concentration and purification. The semi-crystalline fraction obtained retained DEG by means of codissolution and adsorption as demonstrated by thin lay chromatography/flame ionisation detection (TLC/FID). In 3 out of the 15 fatal cases (from Group 1), DEG was isolated from viscera and blood (femoral venous), between 48 and 72 h post ingestion. The concentration relation (DEG)viscera/(DEG)blood ranged from 1.45 to 1.55 with a coefficient correlation r2 = 0.96 (n = 3). In the other victims, DEG could not be detected. The reason for this could be the long survival period of the victims after their ingestion of the syrup. Additionally, putrefying mechanisms could have been operating. Samples of the propolis syrup of each victim were studied by means of nuclear magnetic resonance (NMR) and quantified by gas chromatography/flame ionisation detection (GC/FID). Results showed that syrup samples contained 65.0% (w/v) of diethylene glycol (DEG) and 32.0% (w/v) of propylene glycol (PG). A good correlation between the amount of DEG ingested and the anion gap (r2 = 0.63) for the 15 victims studied could be observed. The lethal dose for human beings estimated in this work ranged from 0.014 to 0.170 mg DEG/kg body weight. This is a lower lethal dose than reported in a separate incident in Haiti. These results may contribute to the understanding of DEG?s metabolic pathway and provides data from lethal doses in humans.
publishDate 2005
dc.date.none.fl_str_mv 2005-10
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/158796
Ferrari, Luis Alberto; Giannuzzi, Leda; Clinical parameters, postmortem analysis and estimation of lethal dose in victims of a massive intoxication with diethylene glycol; Elsevier Ireland; Forensic Science International; 153; 1; 10-2005; 45-51
0379-0738
1872-6283
CONICET Digital
CONICET
url http://hdl.handle.net/11336/158796
identifier_str_mv Ferrari, Luis Alberto; Giannuzzi, Leda; Clinical parameters, postmortem analysis and estimation of lethal dose in victims of a massive intoxication with diethylene glycol; Elsevier Ireland; Forensic Science International; 153; 1; 10-2005; 45-51
0379-0738
1872-6283
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://www.sciencedirect.com/science/article/abs/pii/S0379073805002070
info:eu-repo/semantics/altIdentifier/doi/10.1016/j.forsciint.2005.04.038
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier Ireland
publisher.none.fl_str_mv Elsevier Ireland
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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