Ethylene glycol poisoning.
Ethylene glycol (EG) can be found in many agents, such as antifreeze. Ingestion of EG may cause serious poisoning. Adults are typically exposed when EG is ingested as a cheap substitute for ethanol or in suicide-attempts. Children may be exposed by accidental ingestion caused by decantation of EG to unlabeled bottles. EG has in itself a low toxicity, but is in vivo broken down to four organic acids: glycoaldehyde, glycolic acid, glyoxylic acid and oxalic acid. The metabolites are cell toxins that cause central nervous system depression, and cardio-pulmonary and renal failure. Glycolic acid causes severe acidosis, and oxalate is precipitated as calcium oxalate in the kidneys and other tissues. We present five case reports of fatal EG-poisoning, and review the literature concerning clinical presentation and diagnosis, pathological findings, treatment and prevention.
Leth
Peter Mygind
PM
Institute of Forensic Medicine, University of Southern Denmark, Faculty of Health Sciences, Winsløvparken 17, DK-5000 Odense C, Denmark. pleth@health.sdu.dk
Gregersen
Markil
M
D000138:Acidosis / Q000139:chemically induced; D000328:Adult; D001921:Brain / Q000473:pathology; D002129:Calcium Oxalate / Q000032:analysis; D019855:Ethylene Glycol / Q000506:poisoning*; D049429:Forensic Pathology; D006801:Humans; D007669:Kidney Calculi / Q000737:chemistry / Q000473:pathology; D008099:Liver / Q000473:pathology; D008168:Lung / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000139:chemically induced; D013405:Suicide
D002129:Calcium Oxalate; D019855:Ethylene Glycol