Ferrari L.A., Arado M.G., Wamba Z., Stoichevich M., Stoichevich S.

Laboratory of Toxicology and Legal Chemistry, Buenos Aires Court of Justice. 41 y 119 (1900) La Plata, Argentina

During 1992, massive intoxication caused by propolys syrup used as a therapeutic agent for upper respiratory infections, produced 29 unexpected deaths in Argentina.
Since all victims suffered acute renal insufficiency before death, and histopathological studies showed renal damage, toxicological studies were oriented to demonstrate the ingestion of nephrotoxic substances. Of these, one of the best candidates would be certain toxic glycols, erroneously used as excipients in syrup production, which may be confused with polyethylenglycol (PEG), a normal component of the formula.
Various samples of the propolys syrup were studied by means of GC/MS, and results showed that syrup samples contained 58.5% (v/v) or 65.0% (p/v) of DEG and 31.0% (v/v) or 32.0% (p/v) of PEG.
In viscera and blood from victims who died, a methanol extract was obtained, with ulterior concentration and purification. The semicrystalline fraction obtained retained DEG by means of co-dissolution and adsorption, as demonstrated by GC/FID.
In 4 out of 20 cases studied, DEG was isolated from viscera and blood. In the other victims, DEG could not be detected. This fact may have been due to the long survival period of the victims from syrup ingestion to death. Putrefactive mechanisms may also have been operating. It must be emphatized that, in all cases, propolys syrup ingestion was antecedent and, in most cases, especially those who survived at least 3 or 4 days, DEG was detected in blood samples before death.
The present work discusses the probable biotransformation mechanism of DEG, through etoxyhydroxyacetic acid as a final product. In this sense, histopathological studies could not demonstrate calcium oxalate precipitates in kidney.