Ethylene glycol poisoning: toxicokinetic and analytical factors affecting laboratory diagnosis.
Ethylene glycol poisoning is an important toxicological problem in medical practice because early diagnosis and treatment can prevent considerable morbidity and mortality. When ingested in the form of antifreeze or other automotive products, ethylene glycol results in central nervous system depression, cardiopulmonary compromise, and renal insufficiency. Metabolism of ethylene glycol to organic acids is required for metabolic derangement and organ damage. Laboratory features of ethylene glycol poisoning include increased anion gap metabolic acidosis, increased osmolal gap, calcium oxalate crystalluria, and detectable ethylene glycol in serum. This Case Conference integrates discussion of the toxicokinetic and analytical variables that affect the laboratory diagnosis of ethylene glycol intoxication.
Eder
A F
AF
Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia 19103, USA.
McGrath
C M
CM
Dowdy
Y G
YG
Tomaszewski
J E
JE
Rosenberg
F M
FM
Wilson
R B
RB
Wolf
B A
BA
Shaw
L M
LM
D000138:Acidosis / Q000175:diagnosis; D000293:Adolescent; D000328:Adult; D002129:Calcium Oxalate / Q000652:urine; D002849:Chromatography, Gas; D004796:Clinical Enzyme Tests; D003937:Diagnosis, Differential; D019855:Ethylene Glycol / Q000378:metabolism / Q000493:pharmacokinetics / Q000506:poisoning*; D006801:Humans; D008658:Inactivation, Metabolic; D007669:Kidney Calculi / Q000473:pathology; D007928:Lethal Dose 50; D008297:Male; D008875:Middle Aged; D011041:Poisoning / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D051437:Renal Insufficiency / Q000175:diagnosis; D013406:Suicide, Attempted; D014882:Water-Electrolyte Balance
D002129:Calcium Oxalate; D019855:Ethylene Glycol