A neonate born to a mother who has abused toluene during pregnancy may develop a distal renal tubular acidosis (RTA).



(1) metabolic acidosis with low serum bicarbonate concentration

(2) hyperchloremia

(3) hypokalemia


Clues may include:

(1) maternal history of abusing volatile solvents

(2) maternal renal tubular acidosis

(3) teratogenic features in the neonate consistent with toluene effect

(4) premature delivery and/or growth retardation

(5) positive tests for drugs of abuse

(6) toluene in maternal blood or urine if toluene inhalation has been recent


Differential diagnosis: other causes of renal tubular acidosis


The distal RTA due to toluene exposure should clear in a few days.


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