title: False hyperlactatemia in life-threatening ethylene glycol poisoning.
abstract: Ethylene glycol poisoning is rare, but prompt diagnosis is crucial, in order to initiate specific treatments. Herein, we report the case of a patient who was admitted to ICU for coma and extreme metabolic acidosis with unexpected hyperlactatemia on initial ICU blood gas analyzer. Ethylene glycol poisoning was diagnosed, and hyperlactatemia was ruled out on a blood sample sent to the biochemistry department. Interference of blood gas analyzers lactate electrodes with metabolites of ethylene glycol were the source of this apparent hyperlactatemia. Symptoms gradually improved and false hyperlactatemia resolved after renal replacement therapy and fomepizole administration. Time course of ethylene glycol concentration showed similar evolution. After initial confirmation of ethylene glycol presence, this biological interference could thus be used as a surrogate of costly and highly specialised dosages.
authors.affiliation: Pharmacy department, Cochin Hospital, groupe hospitalier Paris Centre, assistance publique des hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, faculté de pharmacie, 4, avenue de l'Observatoire, 75006 Paris, France.
authors.forename: T
authors.initials: T
authors.lastname: Riquier
authors.affiliation: Medical Intensive Care Unit, Cochin Hospital, groupe hospitalier Paris Centre, assistance publique des hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, faculté de médecine, 15, rue de l'Ecole-de-Médecine, 75006 Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Geri
authors.affiliation: Medical Intensive Care Unit, Cochin Hospital, groupe hospitalier Paris Centre, assistance publique des hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, faculté de médecine, 15, rue de l'Ecole-de-Médecine, 75006 Paris, France. Electronic address: nicolas.mongardon@cch.aphp.fr.
authors.forename: N
authors.initials: N
authors.lastname: Mongardon
authors.affiliation: Toxicology department, Lariboisière Hospital, assistance publique des hôpitaux de Paris, 2, rue Ambroise-Paré, 75010 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, faculté de pharmacie, 4, avenue de l'Observatoire, 75006 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Bourgogne
authors.affiliation: Medical Intensive Care Unit, Cochin Hospital, groupe hospitalier Paris Centre, assistance publique des hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, faculté de médecine, 15, rue de l'Ecole-de-Médecine, 75006 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Pène
mesh_terms: D000140:Acidosis, Lactic / Q000139:chemically induced / Q000628:therapy; D003128:Coma / Q000139:chemically induced; D019855:Ethylene Glycol / Q000097:blood / Q000506:poisoning*; D006703:Ill-Housed Persons; D006801:Humans; D065906:Hyperlactatemia / Q000097:blood / Q000139:chemically induced*; D007674:Kidney Diseases / Q000139:chemically induced / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017582:Renal Replacement Therapy
chemical_list: D019855:Ethylene Glycol
keywords: Acide lactique; Acidose métabolique; Biochemistry; Biochimie délocalisée; Blood gas analysis; Ethylene glycol; Gazométrie artérielle; Intoxication; Lactate; Metabolic acidosis; Toxicology; Éthylène glycol