title: Successful outcome of accidental ethylene glycol poisoning despite delayed presentation.
abstract: A 69-year-old man presented to the emergency department after being found unconscious by his son. He had experienced headache the previous day but had been otherwise well. Investigations revealed a severe metabolic acidosis, raised lactate and acute kidney injury. The calculated anion and osmolar gap were both elevated at 37.7 and 39.3, respectively. Due to his reduced Glasgow coma score (GCS) he was intubated and a CT scan performed: only a small, mature pontine infarct was found of uncertain significance. Further questioning of the family revealed accidental ingestion of 150 ml of a 'blue liquid' 24 h earlier (later identified as car screenwash). With ethylene glycol (EG) poisoning suspected, he was given intravenous ethanol, fomepizole (a competitive inhibitor of alcohol dehydrogenase) and haemofiltration. Despite the delayed presentation, prompt recognition and treatment of EG poisoning led to a successful discharge in this case.
authors: Department of Renal Medicine, Basildon University Hospital, Essex, UK. zmangera@hotmail.com
authors: Zaheer
authors: Z
authors: Mangera
authors: Said
authors: S
authors: Isse
authors: Georgia
authors: G
authors: Winnett
authors: Aroon
authors: A
authors: Lal
authors: Michele
authors: M
authors: Cafferkey
mesh_terms: D000061:Accidents, Home; D000368:Aged; D000931:Antidotes / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003422:Critical Care / Q000379:methods; D016638:Critical Illness / Q000628:therapy*; D057210:Delayed Diagnosis; D019855:Ethylene Glycol / Q000506:poisoning*; D005500:Follow-Up Studies; D000077604:Fomepizole; D015600:Glasgow Coma Scale; D006440:Hemofiltration / Q000379:methods; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D011720:Pyrazoles / Q000008:administration & dosage; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D000931:Antidotes; D011720:Pyrazoles; D000077604:Fomepizole; D019855:Ethylene Glycol