[Severe ethylene glycol intoxication by skin absorption].
Ethylene glycol is present predominantly in antifreeze,and in industrial solvents. Accidental ingestion of ethylene glycol is relatively rare, but may be potentially lethal. It results in a depression of the central nervous system, a severe metabolic acidosis and an acute renal failure by tubular precipitation of calcium oxalate crystals. We report a case of ethylene glycol poisoning by through skin absorption.


METHODS
A 38-year-old man, working in a cement factory, with a history of cutaneous psoriasis for 10 years, was admitted to our hospital due to acute nausea, vomiting and diffuse abdominal pain, followed by generalized convulsive status epilepticus and worsening of his mental status. Biologic analysis showed severe metabolic acidosis and acute renal failure which required hemodialysis. On renal biopsy, there were intratubular crystals of calcium oxalate. Cerebral magnetic resonance imaging showed posterior encephalitis. Evolution was marked by normalization of renal function at two weeks and improvement of the mental status. Retrospectively, the patient's history-taking revealed that he manipulated ethylene glycol without gloves.


CONCLUSIONS
Cutaneous contact with ethylene glycol may cause poisoning in presence of skin lesions. The triad neurologic involvement, renal failure due to oxalate crystals deposits and metabolic acidosis leads to the diagnosis of ethylene glycol intoxication. In the case of acute renal failure with oliguria, haemodialysis is the treatment of choice. It allows the removal of the toxic substance and its metabolites with correction of the metabolic acidosis. The precocity of the treatment may improve the prognosis.
Bouattar
Tarik
T
Service de néphrologie-dialyse-transplantation rénale, CHU Ibn Sina, BP 10000, Rabat, Maroc. tarik1008@hotmail.com
Madani
Naoufel
N
Hamzaoui
Hakim
H
Alhamany
Zaitouna
Z
El Quessar
Abdeljalil
A
Benamar
Loubna
L
Rhou
Hakima
H
Abouqual
Redouane
R
Zeggwagh
Amine
A
Bayahia
Rabea
R
Ouzeddoun
Naima
N
D000042:Absorption; D000328:Adult; D019855:Ethylene Glycol / Q000493:pharmacokinetics* / Q000506:poisoning*; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D012867:Skin / Q000378:metabolism*
D019855:Ethylene Glycol