We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Commentary |

Lessons Learned From Yet Another Episode of Diethylene Glycol Poisoning It Happened Before and It Happened Again

Jeffrey Brent, MD, PhD1,2
[+] Author Affiliations
1Department of Internal Medicine, University of Colorado, School of Medicine, Aurora
2Colorado School of Public Health, Aurora
JAMA Intern Med. 2014;174(6):918-919. doi:10.1001/jamainternmed.2014.19.
Text Size: A A A
Published online


In September 2006, a Panamanian physician noted that there were an unusual number of mostly elderly patients presenting with signs of acute kidney injury, gastroenteritis, and central and peripheral neurological effects of unclear etiology. A cluster of this nature suggests a common-source etiology, which typically could be infectious or toxicological. This prompted the Panamanian Ministry of Health to seek investigative assistance from the US Centers for Disease Control and Prevention (CDC). By October, investigators from the CDC set up a case-control study, with cases defined as individuals presenting, on or after August 2006, with apparent acute kidney injury of unknown etiology. Controls consisted of individuals admitted to the same hospital for reasons other than renal injury and were matched to cases by age and date of admission. Forty-two patients met the case definition. The evaluation of cases included a questionnaire assessing potential recent chemical exposures. Medications taken and urine samples were sent to the CDC. Diethylene glycol (DEG), a known nephrotoxin, was quickly identified as the putative culprit in a cough syrup preparation.1

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

1 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles