Clinical Chemistry, Vol 39, 1922-1925, Copyright © 1993 by American Association for Clinical Chemistry

Severe isopropanolemia without acetonemia or clinical manifestations of isopropanol intoxication

KM Chan, ET Wong and WS Matthews
Department of Pathology and Laboratory Medicine, Los Angeles County- University of Southern California Medical Center 90033.

This is the first reported case of severe isopropanolemia in a patient who did not experience associated clinical manifestations and acetonemia. The patient was found lying face down in a hotel lobby but at admission was alert and oriented to place and person. Toxicological analysis of the patient's serum revealed the presence of isopropanol at a concentration of 72 mmol/L. An increased serum osmolal gap (81 mOsm/kg) was also observed. The serum concentration of isopropanol decreased to 9.5 mmol/L 15.5 h after admission with an estimated half- life of elimination of 5-7 h. No serum acetone was detected throughout the patient's hospitalization. The identity of isopropanol was confirmed by gas chromatography/mass spectrometry. The patient remained awake and alert while in the hospital and was discharged 5 days after admission. These unusual findings raise some fundamental questions about the role of isopropanol conversion to acetone in the manifestation of symptoms usually associated with isopropanol intoxication.