ETHYLENE GLYCOL POISONING WITH CONCURRENT ETHANOL INGESTION
Abstract
Background. Ethylene glycol, usually ingested by coincidence, causes uncommon but serious poisoning which could have fatal consequences without prompt diagnosis and treatment. Ethylene glycol itself has a low toxicity but is rapidly degraded to toxic metabolites, that are responsible for typical clinical presentation. Metabolic acidosis, increased anion and osmolal gap are typical laboratory findings. Application of antidotes ethanol and fomepizol, hemodyalisis and correction of metabolic acidosis are mainstays of therapy.
Patients and methods. A case of concurrent ethanol and ethylene glycol ingestion is presented. On admission diagnosis of ethylene glycol poisoning was supported by heteroanamnestic data, typical clinical presentation and laboratory findings and latter confirmed with body fluid analysis. Despite therapy with ethanol, sodium hydrogencarbonate and parenteral hydration patient developed acute renal failure which required hemodyalisis.
Conclusions. Concurrent ingestion of spirit improved prognosis of ingestion of lethal ethylene glycol dose. Due to late arrival adequate and immediate in-hospital management could not prevent acute renal failure and subsequent hemodyalisis.
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References
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