Butoxyethanol Ingestion with Prolonged Hyperchloremic Metabolic Acidosis Treated with Ethanol Therapy

Background: Severe toxic ingestions of butoxyethanol (CAS No. 111-76-2) are rare despite the prevalence of this glycol ether in products such as glass and surface cleaners. Manifestations of acute butoxyethanol toxicity include metabolic acidosis, hemolysis, hepatorenal dysfunction, and coma, but va...

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Bibliographic Details
Published in:Journal of toxicology. Clinical toxicology 2000, Vol.38 (7), p.787-793
Main Authors: McKinney, Patrick E., McKinney, Patrick, Palmer, Robert B., Blackwell, Walter, Benson, Blaine E.
Format: Article
Language:English
Subjects:
Acidosis - chemically induced
Acidosis - drug therapy
Animals
Biological and medical sciences
butyl cellosolve
Chemical and industrial products toxicology. Toxic occupational diseases
Ethanol - therapeutic use
Ethylene Glycols - blood
Ethylene Glycols - metabolism
Ethylene Glycols - pharmacokinetics
Ethylene Glycols - poisoning
Female
Humans
Medical sciences
Middle Aged
Rats
Solvents - poisoning
Time Factors
Toxicology
Various organic compounds
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Summary:Background: Severe toxic ingestions of butoxyethanol (CAS No. 111-76-2) are rare despite the prevalence of this glycol ether in products such as glass and surface cleaners. Manifestations of acute butoxyethanol toxicity include metabolic acidosis, hemolysis, hepatorenal dysfunction, and coma, but vary widely in reported cases. Furthermore, the optimal therapeutic approach is not yet established. Much of the toxicity of butoxyethanol has been ascribed to its aldehyde and acid metabolites which are similar to those produced by oxidative metabolism of methanol and ethylene glycol. Although the roles of alcohol dehydrogenase inhibition with ethanol or fomepizole and hemodialysis are clear in the case of toxic ingestions of methanol and ethylene glycol, they remain poorly defined for butoxyethanol poisoning. Case Report: We report the case of a 51-year-old female who ingested up to 8 ounces of Sanford Expo White Board Cleaner® (butoxyethanol and isopropanol). She developed prolonged hyperchloremic metabolic acidosis and mental status depression and was treated with ethanol therapy but not hemodialysis. This patient recovered without apparent sequelae. The kinetics of butoxyethanol metabolism in this case are described and the potential therapeutic options are discussed.
ISSN:0731-3810
1097-9875
DOI:10.1081/CLT-100102393