METABOLIC-ACIDOSIS AND RENAL TUBULAR INJURY DUE TO PURE TOLUENE INHALATION

A 22-y-old woman was hospitalized for muscle weakness of her lower ext remities after she sniffed approximately 6 l of pure toluene during th e month prior to admission. The examinations on serum and urine reveal ed mixed hyperchloremic and high anion gap metabolic acidosis accompan ied by impaired urinary acidification. Histopathological changes of th e kidney were patchy areas of tubular injury. Acidosis normalized on t he fourth day of admission, but both proximal and distal tubular dysfu nction persisted. These findings indicate that toluene is a tubular to xin and may contribute to the development of distal renal tubular acid osis.