Toxic alcohol but not intoxicated--a case report.
Ethylene glycol is recognised as a potentially lethal poison if ingested. Approximately 100 mls may be fatal in a 70 kg adult. Current Toxbase guidelines are the accepted standard of treatment of such poisonings in the United Kingdom. These guidelines suggest that symptoms of significant poisoning are usually present within 30 minutes of ingestion i.e. ataxia, dysarthria, nystagmus, nausea and vomiting, haematemesis, coma and convulsions. In the absence of these symptoms, metabolic acidosis or ethylene glycol concentration more than 8 mmol/l a single loading dose of ethanol and observation were the recommended course of management until recently. We report a case of a patient who remained relatively asymptomatic for almost 24 hours but then developed clinical symptoms with marked metabolic acidosis and renal impairment requiring intensive treatment including haemodialysis.
Symington
L
L
Accident and Emergency, Ninewells Hospital, Dundee DD1 9SY. linda.r.symington@tuht.scot.nhs.uk
Jackson
L
L
Klaassen
B
B
D000138:Acidosis / Q000139:chemically induced* / Q000503:physiopathology / Q000628:therapy; D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy*; D000328:Adult; D000931:Antidotes / Q000627:therapeutic use*; D001774:Blood Chemical Analysis; D001784:Blood Gas Analysis; D019855:Ethylene Glycol / Q000506:poisoning*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007677:Kidney Function Tests; D006435:Renal Dialysis / Q000379:methods; D018570:Risk Assessment; D013406:Suicide, Attempted; D016896:Treatment Outcome
D000931:Antidotes; D019855:Ethylene Glycol