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Basal Ganglion Hemorrhage as Delayed Complication of Diethylene Glycol Ingestion

Gupta, Avneesh MD; Diaz, Francisco J. MD; Lal, Anita MD; Sung, Lokman MD; Aaron, Cynthia K. MD, FACEP, FACMT

The American Journal of Forensic Medicine and Pathology: March 2017 - Volume 38 - Issue 1 - p 39–42
doi: 10.1097/PAF.0000000000000295
Case Reports
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Diethylene glycol (DEG), an organic compound (HOCH2CH2)2O is a commonly used solvent. Mass poisoning outbreaks have been reported because of frequent contaminations. A PubMed search for diethylene resulted in 795 publications with 151 specifically discussing the toxicity. Of the 151 reported toxicity reviews/case reports, only 6 publications discussed the long-term neurological effects of diethylene toxicity. We report a fatal case of oral ingestion of DEG with complications from delayed toxicity. She died 7 days after the second admission. Autopsy disclosed a right basal ganglia hemorrhage within the brain and microscopic deposits of polarizable crystals into small cerebral blood vessels. Both kidneys illustrate tubular necrosis with scattered tubular deposition of polarizable calcium oxalate crystals. PubMed search leads to only 2 reported cases of basal ganglia hemorrhage (based on radiological findings) after ethylene glycol intoxication. Our case is the first reportable case of basal ganglia hemorrhage after DEG ingestion.

From the *Department of Pathology, †Department of Pathology, University of Michigan, Detroit, MI; ‡Forensic Services and Coroner's Complex, Provincial Forensic Pathology, Toronto, Ontario, Canada; §Department of Pathology, University of Michigan, Ann Arbor; and ∥Michigan Regional Poison Control Center, Children's Hospital of Michigan, Detroit, MI.

Manuscript received July 29, 2016; accepted November 20, 2016.

The authors report no conflict of interest.

Reprints: Avneesh Gupta, MD, Department of Pathology, University of Michigan, 1301 Catherine ST, Room 5226, Med SC1, Ann Arbor, MI, 48109. E-mail: avgupta@umich.edu.

© 2017 by Lippincott Williams & Wilkins.