Ethylene Glycol Intoxication

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Contents 1 Pathology 2 Clinical-manifestations 3 Laboratory 4 Management 5 More General Terms 6 Additional Terms 7 References

Pathology

• when ingested, ethylene glycol is rapidly metabolized to oxalate

Clinical-manifestations

• metabolic acidosis
• central nervous system dysfunction
• nephrocalcinosis ( calcium oxalate cystals)
• renal failure
• sweet, fruity breath

Laboratory

• anion gap metabolic acidosis

• arterial blood gas
• chem7 (calculate anion gap)

• serum Na+
• serum bicarbonate
• serum chloride

• serum ketones are negative
• urinalyis:

• hematuria
• oxalate crystals in urine (rectangular)

• direct measurement of ethylene glycol in serum

Management

• fomepizole (Antizol) agent of choice [1]
• ethanol 10% solution

• loading dose: 10 mL/kg
• maintenance dose: 1.5 mL/kg
• titrate to blood alcohol level of 22 mmol/L (100 mg/dL)

• hemodialysis
• ICU may be appropriate

More General Terms

• toxicity; poisoning; overdose

Additional Terms

• ethylene glycol

References

1. Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 15, American College of Physicians, Philadelphia 1998, 2006, 2009
2. eMedicine: Toxicity, Ethylene Glycol [1]

ethylene glycol intoxication