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Syndromes of Toluene Sniffing in Adults

HOWARD Z. STREICHER, M.D.; PATRICIA A. GABOW, M.D.; ALVIN H. MOSS, M.D.; DWIGHT KONO, M.D.; and WILLIAM D. KAEHNY, M.D.
[+] Article and Author Information

Grant support: in part by the National Kidney Foundation of the Rocky Mountain Region and by the Veterans Administration. Dr. Gabow was a Teaching and Research Scholar of the American Heart Association.

▸Requests for reprints should be addressed to William D. Kaehny, M.D.; Renal Section 111C, Veterans Administration Medical Center; Denver, CO 80220.


Honolulu, Hawaii; and Denver, Colorado


© 1981 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1981;94(6):758-762. doi:10.7326/0003-4819-94-6-758
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Clinical and laboratory findings in 25 adults, ages ranging from 18 to 40 years, who were hospitalized for problems related to paint sniffing are presented. All but one were chronically unemployed. Three different patterns of symptoms led to hospitalization: muscle weakness (n = 9), gastrointestinal complaints including abdominal pain and hematemesis (n = 6) and neuropsychiatric disorders including altered mental status, cerebellar abnormalities, and peripheral neuropathy (n = 10). Hypokalemia (n = 13), hypophosphatemia (n = 10), hyperchloremia (n = 22), and hypobicarbonatemia (n = 23) were common. The average serum potassium and phosphorus concentrations of 1.7 mmol/L and 1.5 mg/dL were significantly lower in the muscle weakness group than in the other two groups. Rhabdomyolysis occurred in 10 patients. Hyperchloremic acidosis was found in 19 of 22 patients evaluated. The muscle weakness and gastrointestinal syndromes resolved within 1 to 3 days with abstinence from sniffing and repletion of fluid and electrolyte stores. Inhalation of paint or glue vapors should be considered in the differential diagnosis of the symptoms and laboratory findings described above.

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