Citation

Rathnapala A, Matthias T, Jayasinghe S. J. Med. Case Reports 2012; 6.

Copyright

(Copyright © 2012, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/1752-1947-6-18

PMID

unavailable

Abstract

Introduction. Kerosene is a freely accessible hydrocarbon used in Sri Lankan (and other Asian) households for cooking and for lighting lamps. Kerosene poisoning is rarely reported among adults and its toxicological effects are not well known. Metformin is a commonly used oral hypoglycemic drug and its overdose leads primarily to lactic acidosis. Combined poisoning of metformin and kerosene and their interactions have not been reported. Case presentation. An 18-year-old, previously healthy, unmarried Sinhalese woman was referred following ingestion of 17.5 g of metformin and approximately 200 mL of kerosene oil in a suicide attempt. She had vomiting, burning epigastric pain, and a hypoglycemic seizure (capillary blood glucose of 42 mg/dL). Subsequently, she developed severe lactic acidosis followed by acute renal insufficiency, was treated with sodium bicarbonate, and underwent intermittent hemodialysis with bicarbonate. She recovered completely.

CONCLUSIONS: This report proposes possible interactions that occur between metformin and kerosene that augment toxicity when the two are ingested together. It also stresses the importance of early treatment with intermittent hemodialysis in severe lactic acidosis with maintenance of blood glucose. © 2012 Rathnapala et al; licensee BioMed Central Ltd.

Language: en

Keywords

adult; human; female; case report; hemodialysis; suicide attempt; disease severity; drug overdose; article; vomiting; priority journal; physical examination; patient referral; seizure; patient transport; acute kidney failure; glucose blood level; epigastric pain; glucose; bicarbonate; hypoglycemia; creatinine; creatinine blood level; kerosene; ampicillin; metabolic acidosis; lactic acidosis; metformin; kidney function; lactate blood level; ranitidine; arterial gas; urine volume; lactic acid; capillary blood; blood flow velocity