Question of the Day – Thursday November 29, 2018

Question – Methylethylketone peroxide (MEKP) is an organic peroxide whose toxicity is linked primarily to the formation of excessive free radicals following ingestion. What injuries have been identified following ingestion of this chemical?

Answer – The cited reference notes “The presence of free radicals induces lipid peroxidation of target organs, particularly of the digestive tract and the liver. The digestive tract in this intoxication is exposed directly to the agent after ingestion, which explains why this agent is more likely to induce proximal than distal lesions. The liver is exposed to MEKP only after systemic absorption. This may induce acute liver failure, which is the major cause of death in this intoxication. Survivors, on the other hand, often suffer gastrointestinal sequelae due to fibrotic and stenotic repair reactions following the acute phase insult. Additionally the formation of the organic acids may cause metabolic acidosis, local burns of skin and mucosa on contact, and induce neurologic lesions such as inflammation and ischemia of the optic nerve.” (Van Enckevort CCG eta l. N-acetylcysteine and hemodialysis treatment of a sever case of methyl ethyl ketone peroxide intoxication. 2009 Clin Tox 46(1): 74-78)