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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Acute kidney injury due to intravenous detergent poisoning: A case report
Sungbin Park, Hyun-Sik Ryu, Jae-Kwang Lee, Sung-Soo Park, Sun-Jung Kwon, Won-Min Hwang, Sung-Ro Yun, Moon-Hyang Park, Yohan Park
Sungbin Park, Won-Min Hwang, Sung-Ro Yun, Yohan Park, Department of Internal Medicine, Division of Nephrology, Konyang University Hospital, College of Medicine, Daejeon 35365, South Korea
Hyun-Sik Ryu, Jae-Kwang Lee, Sung-Soo Park, Department of Emergency Medicine, Konyang University Hospital, College of Medicine, Daejeon 35365, South Korea
Sun-Jung Kwon, Department of Internal Medicine, Division of Respiratory and Critical Care Medicine, Konyang University Hospital, College of Medicine, Daejeon 35365, South Korea
Moon-Hyang Park, Department of Pathology, Konyang University Hospital, College of Medicine, Daejeon 35365, South Korea
Author contributions: Park S and Park Y were the patient’s attending physician, reviewed the literature and contributed to manuscript drafting; Ryu HS, Lee JK, Park SS, Kwon SJ involved in the data curation; Park MH interpreted the pathologic findings, reviewed the literature and drafted the manuscript; Hwang WM and Yun SR supervised the findings of this work; Park Y were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Yohan Park, MD, Assistant Professor, Department of Internal Medicine, Division of Nephrology, Konyang University Hospital, College of Medicine, Gwanjeodong-ro 158, Seo-gu, Daejeon 35365, South Korea. nofever38@kyuh.ac.kr
Received: September 26, 2021
Peer-review started: September 26, 2021
First decision: October 18, 2021
Revised: October 28, 2021
Accepted: January 11, 2022
Article in press: January 11, 2022
Published online: February 26, 2022
BACKGROUND
Detergent poisoning mostly occurs through oral ingestion (> 85%), ocular exposure (< 15%), or dermal exposure (< 8%). Reports of detergent poisoning through an intravenous injection are extremely rare. In addition, there are very few cases of renal toxicity directly caused by detergents. Here, we report a unique case of acute kidney injury caused by detergent poisoning through an accidental intravenous injection.
CASE SUMMARY
A 61-year-old man was intravenously injected with 20 mL of detergent by another patient in the same room of a local hospital. The surfactant and calcium carbonate accounted for the largest proportion of the detergent. The patient complained of vascular pain, chest discomfort, and nausea, and was transferred to our institution. After hospitalization, the patient’s serum creatinine level increased to 5.42 mg/dL, and his daily urine output decreased to approximately 300 mL. Renal biopsy findings noted that the glomeruli were relatively intact; however, diffuse acute tubular injury was observed. Generalized edema was also noted, and the patient underwent a total of four hemodiafiltration sessions. Afterward, the patient’s urine output gradually increased whereas the serum creatinine level decreased. The patient was discharged in a stable status without any sequelae.
CONCLUSION
Detergents appear to directly cause renal tubular injury by systemic absorption. In treating a patient with detergent poisoning, physicians should be aware that the renal function may also deteriorate. In addition, timely renal replacement therapy may help improve the patient’s prognosis.
Core Tip: Reports of detergent poisoning through an intravenous injection are extremely rare. Here, we report a case of acute kidney injury caused by detergent poisoning through an accidental intravenous injection. The patient progressed to acute kidney injury after administration of detergent. Kidney biopsy showed diffuse acute tubular injury. This case demonstrates that detergent directly cause tubular injury by systemic absorption. In addition, this case shows that renal replacement therapy at an appropriate time is helpful for the patient’s prognosis.
