[Diagnostic and therapeutic management of ethylene glycol poisoning. Importance of crystalluria. Apropos of a case].
During the course of a case of ethylene glycol poisoning with ensuing oliguric renal failure despite early dialysis, we show the importance of early diagnosis of this intoxication in underlined. Characteristics of ethylene glycol poisoning are: metabolic acidosis with anion gap (without lactic acidosis or keto-acidosis) and high plasma osmolarity. Awaiting the result of blood and urinary toxic values, crystalluria, by typical needle monohydrate calcium oxalate crystals finding, evokes the diagnosis and permits to start a specific treatment. This treatment is based on: principles of intensive care, ethanol administration (or 4-methyl-pyrazole now available), also thiamine and pyridoxine administration and finally, dialysis therapy. We can hope, with early and intensive management of this poisoning, to prevent the renal failure, principal complication of ethylene glycol ingestion, which can lead to chronic renal failure. Therefore, crystalluria, an easy and specific diagnosis technic, is of great interest.
Andreelli
F
F
Service de Médecine Interne, Centre Hospitalier Général de Beauvais.
Blin
P
P
Codet
M P
MP
Fohrer
P
P
Lambrey
G
G
Massy
Z
Z
D000138:Acidosis / Q000139:chemically induced; D058186:Acute Kidney Injury / Q000139:chemically induced / Q000628:therapy; D000437:Alcoholism / Q000150:complications; D002129:Calcium Oxalate / Q000652:urine*; D003128:Coma / Q000139:chemically induced; D003404:Creatinine / Q000097:blood; D000431:Ethanol / Q000627:therapeutic use; D019855:Ethylene Glycol; D005026:Ethylene Glycols / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009846:Oliguria / Q000139:chemically induced; D011041:Poisoning / Q000175:diagnosis / Q000628:therapy; D006435:Renal Dialysis
D005026:Ethylene Glycols; C016189:whewellite; D002129:Calcium Oxalate; D000431:Ethanol; D003404:Creatinine; D019855:Ethylene Glycol
Prise en charge diagnostique et thérapeutique de l'intoxication par l'éthylène glycol. Intérêt de la cristallurie. A propos d'une observation.