Ethylene glycol intoxication: evaluation of kinetics and crystalluria.
Ethylene glycol and glycolate kinetics were studied in two cases of ethylene glycol intoxication with maximal ethylene glycol/glycolate concentrations of 40.9/26.8 and 56.4/22.4 mmol/liter, respectively. Both patients survived, but with prolonged renal failure, upon treatment with bicarbonate, ethanol, and hemodialysis. Glycolic acid was the major cause of the metabolic acidosis in both cases; lactate levels were only slightly elevated. Kinetic calculations showed that both ethylene glycol and glycolate were distributed in total body water with plasma half-lives of 8.4 and 7.0 hours, respectively. The half-life of ethylene glycol was increased more than 10-fold by ethanol treatment alone. Calcium oxalate monohydrate crystalluria was dominant in both cases, but in one was preceded by a short period with mainly dihydrate excretion; crystalluria was not present upon admission. Repetitive urine microscopy in search of needle- or envelope-shaped crystals should be performed when ethylene glycol intoxication is suspected.
Jacobsen
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D
Department of Pharmacology, Louisiana State University Medical Center, Shreveport 71130-3932.
Hewlett
T P
TP
Webb
R
R
Brown
S T
ST
Ordinario
A T
AT
McMartin
K E
KE
D000138:Acidosis / Q000139:chemically induced; D058186:Acute Kidney Injury / Q000139:chemically induced; D000328:Adult; D019855:Ethylene Glycol; D005026:Ethylene Glycols / Q000493:pharmacokinetics / Q000506:poisoning*; D005260:Female; D006016:Glycolates / Q000493:pharmacokinetics; D006207:Half-Life; D006801:Humans; D013406:Suicide, Attempted; D013997:Time Factors; D014556:Urine / Q000032:analysis
D005026:Ethylene Glycols; D006016:Glycolates; D019855:Ethylene Glycol