Severe glycerol intoxication after Menière's disease diagnostic – case report and overview of kinetic data

Abstract

Objective. Despite the fact that glycerol is well known as a nontoxic substance, intoxication with this tertiary alcohol is possible. We report on a 72-year-old male who was referred to the Department of Neurology with progressive neurological symptoms that had developed 4 h prior to admission. Temporally associated was the so-called glycerol test or Klockhoff test, which was performed for the diagnosis of suspected Menière's disease. The test procedure starts with oral administration of glycerol, the maximal dose should not exceed 1.5 g/kg of body weight. Methods. Because of an apparently pathologically highly elevated serum concentration of triglycerides (3,465 mg/dL) measured 10 h after glycerol administration, the suspicion of an overdose of glycerol rose. During the following day, the glycerol serum concentration was analyzed at three different times. Results. Based on these measurements, we determined pharmacokinetic parameters and estimated the initially ingested amount of glycerol of about 3.88–3.95 g/kg body weight. Conclusion. We conclude that an accidental overdose of glycerol must have occurred during the glycerol test to the patient.

Keywords :

• Glycerol
• Intoxication
• Kinetics
• Encephalopathy
• Poisoning

Acknowledgment

We thank Dr. Herbert Desel, GIZ-Nord Poison Center (Göttingen, Germany), for additional information.