Glue, paint, or toluene sniffers may develop signs of renal toxicity including proteinuria, hematuria, and pyuria (1) and distal renal tubular acidosis (2). A glue sniffer with reversible Fanconi's syndrome in addition to distal renal tubular acidosis is described.
A 27-year-old woman was hospitalized for evaluation of profound weakness. She reported inhaling glue from a plastic bag daily for 9 months before admission but denied use of drugs or medications. On admission the patient was lethargic, smelled of glue, and had dried glue on her face. Weakness, dysmetria, dysdiadochokinesia, and ataxia were prominent. She had a severe hyperchloremic metabolic acidosis,