title: Ethylene glycol poisoning: a rare but life-threatening cause of metabolic acidosis-a single-centre experience.
abstract: BACKGROUND
  Intoxication with ethylene glycol happen all around the world and without rapid recognition and early treatment, mortality from this is high.
  
  
  METHODS
  In our study, we retrospectively analysed six cases of ethylene glycol intoxication in our department. We measured ethylene glycol or glycolate levels, lactate levels and calculated the osmolal and anion gap.
  
  
  RESULTS
  Data from six patients admitted to the nephrology department between 1999 and 2011 with ethylene glycol poisoning are reported. All patients were men. The mean pH on admission was 7.15 ± 0.20 and the anion and osmolal gap were elevated in five of six patients. Four patients had an acute kidney injury and one patient had an acute-on-chronic kidney injury. All patients survived and after being discharged, two patients required chronic intermittent haemodialysis. Interestingly, at the time of admission, all patients had elevated lactate levels but there was no linear regression between toxic levels and lactate levels and no linear correlation was found between initial lactate levels and anion gap and osmolal gap.
  
  
  CONCLUSIONS
  The initial diagnosis of ethylene glycol poisoning is difficult and poisoning with ethylene glycol is rare but life threatening and needs rapid recognition and early treatment. Therefore, intoxication with ethylene glycol should not be misdiagnosed as lactic acidosis in patients with metabolic acidosis and elevated lactate levels.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Robert-Bosch Hospital, Stuttgart, Germany.
authors.forename: Joerg
authors.initials: J
authors.lastname: Latus
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Robert-Bosch Hospital, Stuttgart, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Kimmel
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Robert-Bosch Hospital, Stuttgart, Germany.
authors.forename: Mark Dominik
authors.initials: MD
authors.lastname: Alscher
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Robert-Bosch Hospital, Stuttgart, Germany.
authors.forename: Niko
authors.initials: N
authors.lastname: Braun
keywords: acute kidney injury; ethylene glycol poisoning; lactate levels