Brain death with calcium oxalate deposition in the kidney: clue to the diagnosis of ethylene glycol poisoning.
A young man presented to the emergency department with mental status changes, severe metabolic acidosis, and oliguria. Acute ethylene glycol intoxication was diagnosed. The patient suffered clinical brain death three days after admission despite intensive care and continuous hemodiafiltration. The patient died one month after admission. Autopsy revealed acute tubular necrosis of the kidneys with significant calcium oxalate depositions. The brain was markedly softening and with chronic meningoencephalitis and dural sinus thrombosis. We considered that the amount and the persistence of the calcium oxalate deposition in the kidney may afford a best clue to the postmortem diagnosis of ethylene glycol poisoning even in the chronic stage.
Takahashi
Shirushi
S
Division of Forensic Medicine, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, 980-8575 Sendai, Japan. shirushi@forensic.med.tohoku.ac.jp <shirushi@forensic.med.tohoku.ac.jp>
Kanetake
Jun
J
Kanawaku
Yoshimasa
Y
Funayama
Masato
M
D000328:Adult; D001921:Brain / Q000473:pathology; D001926:Brain Death; D002129:Calcium Oxalate / Q000032:analysis*; D019855:Ethylene Glycol / Q000506:poisoning*; D049429:Forensic Pathology; D006801:Humans; D007668:Kidney / Q000737:chemistry* / Q000473:pathology; D007673:Kidney Cortex Necrosis / Q000473:pathology; D008297:Male; D008590:Meningoencephalitis / Q000473:pathology; D011041:Poisoning / Q000175:diagnosis; D012851:Sinus Thrombosis, Intracranial / Q000473:pathology
D002129:Calcium Oxalate; D019855:Ethylene Glycol