Diagnosis and treatment of an unusual cause of metabolic acidosis: ethylene glycol poisoning.
Ethylene glycol intoxication is a rare but dangerous type of poisoning. It causes a severe acidosis with high anion and osmolal gaps. Clinical manifestations of the ethylene glycol intoxication can be divided in three phases: a neurologic stage, with hallucinations, stupor and coma; the second stage is cardiovascular with cardiac failure. Renal failure characterizes the third stage, due to acute tubular necrosis. After aggressive gastric emptying, the main treatment is ethanol or 4-methypyrazole, which can be given either orally or intravenous, with supportive measures for all symptoms or diseased organ.
Piagnerelli
M
M
Service de Médecine Interne, C.H.U. André Vésale, Université Libre de Bruxelles, Montigny-le-Tilleul, Belgique. piagnerelli@hotmail.com
Lejeune
P
P
Vanhaeverbeek
M
M
D000137:Acid-Base Imbalance / Q000139:chemically induced; D000138:Acidosis / Q000209:etiology*; D000426:Alcohol Dehydrogenase / Q000037:antagonists & inhibitors; D000931:Antidotes / Q000627:therapeutic use; D001855:Bone Marrow Diseases / Q000139:chemically induced; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D000431:Ethanol / Q000627:therapeutic use; D019855:Ethylene Glycol / Q000506:poisoning*; D005260:Female; D005500:Follow-Up Studies; D000077604:Fomepizole; D006801:Humans; D008875:Middle Aged; D009994:Osmolar Concentration; D011720:Pyrazoles / Q000627:therapeutic use; D051437:Renal Insufficiency / Q000139:chemically induced; D012128:Respiratory Distress Syndrome / Q000139:chemically induced; D013406:Suicide, Attempted
D000931:Antidotes; D004791:Enzyme Inhibitors; D011720:Pyrazoles; D000431:Ethanol; D000077604:Fomepizole; D000426:Alcohol Dehydrogenase; D019855:Ethylene Glycol