From the Guidelines
Laboratory findings in isopropyl alcohol poisoning typically include an elevated osmolar gap, which is the most characteristic finding. Patients often present with normal or low anion gap metabolic acidosis, unlike ethylene glycol or methanol poisoning which cause high anion gap metabolic acidosis. Blood tests may reveal elevated isopropyl alcohol levels, and its primary metabolite, acetone, can be detected in both blood and urine 1. Hypoglycemia may occur in severe cases. Liver function tests might show mild elevations, though significant hepatotoxicity is uncommon. Renal function tests are usually normal unless severe hypotension has caused acute kidney injury. Complete blood count may demonstrate leukocytosis. Importantly, ketosis without significant acidosis is a distinctive feature of isopropyl alcohol poisoning, as acetone does not further metabolize to acidic compounds. Serum electrolytes typically show normal potassium levels, though sodium abnormalities may occur with severe poisoning. These laboratory findings, particularly the elevated osmolar gap with ketosis but minimal acidosis, help differentiate isopropyl alcohol poisoning from other toxic alcohol ingestions.
Some key points to consider in the laboratory findings of isopropyl alcohol poisoning include:
- Elevated osmolar gap
- Normal or low anion gap metabolic acidosis
- Presence of acetone in blood and urine
- Hypoglycemia in severe cases
- Mild elevations in liver function tests
- Normal renal function tests unless complicated by acute kidney injury
- Leukocytosis on complete blood count
- Ketosis without significant acidosis
It's worth noting that the provided evidence primarily discusses ethylene glycol poisoning, which has different laboratory findings and treatment approaches compared to isopropyl alcohol poisoning. However, the general principles of toxic alcohol ingestions and the importance of laboratory findings in diagnosis and management can still be applied 1.
The most critical aspect of managing isopropyl alcohol poisoning is prompt recognition and treatment to prevent morbidity and mortality. Given the lack of direct evidence on isopropyl alcohol poisoning in the provided studies, the focus should be on general principles of toxicology and the specific characteristics of isopropyl alcohol toxicity. The provided information on ethylene glycol poisoning serves as a reminder of the importance of understanding the unique aspects of each toxic substance and applying that knowledge to clinical practice 1.
From the Research
Laboratory Findings of Isopropyl Alcohol Poisoning
The laboratory findings of isopropyl alcohol poisoning include:
- Elevated plasma osmolality 2
- Osmolar gap 2, 3, 4, 5, 6
- Elevated isopropanol level 2
- Elevated acetone level 2
- Ketonemia 3
- Ketonuria without hyperglycemia or acidosis 3
- Hyperosmolality alone, without metabolic acidosis or increased anion gap 5, 6
Additional Laboratory Abnormalities
Other laboratory abnormalities that may be present in isopropyl alcohol poisoning include:
- Hypoglycemia 2
- Hypothermia 2
- Acute encephalopathy 2
- Metabolic acidosis with increased anion gap (although this is more commonly associated with other types of alcohol poisoning, such as methanol and ethylene glycol) 4, 5, 6
Importance of Early Diagnosis and Treatment
Early diagnosis and treatment of isopropyl alcohol poisoning are crucial to prevent significant morbidity and mortality 4, 5, 6. Hemodialysis may be necessary in severe cases to remove the unmetabolized alcohol and its metabolites 2, 3, 4, 6.