Fatal renal failure caused by diethylene glycol in paracetamol elixir: the Bangladesh epidemic

OBJECTIVE: To determine the cause of a large increase in the number of children with unexplained renal failure. DESIGN: Case-control study. SETTING: Children's hospital in Dhaka, Bangladesh. SUBJECTS: Cases were all 339 children with initially unexplained renal failure; controls were 90 children with cause of renal failure identified; all were admitted to hospital during 35 months after January 1990. MAIN OUTCOME MEASURES: Differences between the case and control patients in clinical and histological features and outcome; toxicological examination of 69 bottles of paracetamol from patients and pharmacies. RESULTS: Compared with children with an identified cause for their renal failure, children with initially unexplained renal failure were significantly (P < 0.05) more likely to have hepatomegaly (58% v 33%), oedema (37%…