The Experience of Using Urinary Liver-Type Fatty Acid-Binding Protein for Follow-Up of Toluene Poisoning: A Case Report

• Published in: Curēus (Palo Alto, CA) Vol. 15; no. 12; p. e50438
• Main Authors: Fujikawa, Hironari, Ichibayashi, Ryo, Sato, Tomoka, Shimizu, Momoko
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 13.12.2023
• Subjects: Acidosis; Blood; Cardiac stress tests; Case reports; Consciousness; Creatinine; Fatty acids; Hospitalization; Metabolism; Paints; Poisoning; Proteins; Rhabdomyolysis; Solvents; Toxicity; Uric acid; Urine; Working conditions; Japan; toluene poisoning; chronic toluene toxicity; renal tubular acidosis; bicarbonate stress test; liver-type fatty acid-binding protein
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.50438

Toluene poisoning is diagnosed based on toluene exposure history and the level of hippuric acid in the urine. Regular blood and urine tests are performed for follow-up. A 54-year-old man collided with a utility pole while driving a car and was rushed to our hospital with a complaint of loss of consciousness. Although the trauma was minor, toluene poisoning was suspected based on the presence of impaired consciousness, occupation is a painting job that involves toluene, and the presence of metabolic acidosis of the normal anion gap. Urinary hippuric acid and urinary liver-type fatty acid-binding protein (L-FABP) were measured, and a diagnosis of renal tubular acidosis (RTA) due to toluene toxicity was made. Urinary L-FABP levels decreased as the condition improved. Urinary L-FABP is a practical and rapid diagnostic and follow-up tool for toluene-induced RTA, and it is helpful to measure it in addition to conventional methods.