Rare case of Isopropanol poisoning through transdermal absorption delayed by dialysis: A report

USA: A recent case study published in the American Journal of Case Reports describes the case of unintentional isopropanol poisoning through transdermal absorption delayed by weekly hemodialysis in a 67-year-old lady. 

Isopropanol poisoning is the most often reported hazardous alcohol consumption in the United States, and emergency physicians are well aware of it. The majority of toxicities are caused by unintended ingestion of rubbing alcohol; nevertheless, transdermal absorption is an under-recognized form of unintentional toxicity. Furthermore, hemodialysis effectively eliminates isopropanol and its metabolites from circulation, thus toxicity can be delayed in individuals getting frequent hemodialysis.

A 67-year-old lady on once-weekly hemodialysis for end-stage renal disease owing to insulin-dependent type II diabetes arrived at the Emergency Department with acute encephalopathy, severe hypoglycemia, and hypothermia. She was disoriented and drowsy, smelled of acetone, and was holding a bottle of rubbing alcohol in her palm. The patient had been topically applying significant amounts of rubbing alcohol as a home treatment for cramping for several months and firmly denied any oral absorption. The patient was disoriented, acutely hypoglycemia, and hypothermic when he arrived. Additional testing indicated that the plasma osmolality, osmolar gap, isopropanol level, and acetone level were all increased. She was admitted to the Intensive Care Unit after receiving supportive care such as glucose-containing fluids and external warming. Hemodialysis was restarted, and the patient was released three days later with stable blood glucose levels, a normal body temperature, and a baseline mental state.