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[Severe ethylene glycol intoxication by skin absorption]
Tarik Bouattar1, Naoufel Madani, Hakim Hamzaoui
1Service de néphrologie-dialyse-transplantation rénale, CHU Ibn Sina, BP 10000, Rabat, Maroc. tarik1008@hotmail.com
Nephrologie & Therapeutique
|March 6, 2009
Summary
Ethylene glycol poisoning can occur through skin absorption, especially with existing skin lesions. Prompt hemodialysis is crucial for treating severe metabolic acidosis and acute kidney injury caused by this toxic exposure.
Area of Science:
- Toxicology
- Nephrology
- Dermatology
Background:
- Ethylene glycol, commonly found in antifreeze and industrial solvents, is a potentially lethal substance.
- Accidental ingestion is rare, but severe toxicity can manifest as central nervous system depression, metabolic acidosis, and acute kidney injury.
- Kidney damage results from calcium oxalate crystal precipitation within renal tubules.
Observation:
- A 38-year-old man with a history of psoriasis developed severe nausea, vomiting, abdominal pain, and seizures after manipulating ethylene glycol without gloves.
- Biologic analysis revealed severe metabolic acidosis and acute renal failure requiring hemodialysis.
- Renal biopsy confirmed intratubular calcium oxalate crystals, and MRI showed posterior encephalitis.
Findings:
- Cutaneous absorption of ethylene glycol can lead to systemic poisoning, particularly in individuals with compromised skin integrity.
- The clinical presentation includes neurological symptoms, severe metabolic acidosis, and acute kidney injury due to oxalate crystal deposition.
- Hemodialysis is an effective treatment for removing ethylene glycol and its metabolites, correcting acidosis, and improving renal function.
Implications:
- This case highlights the risk of ethylene glycol poisoning via skin absorption, emphasizing the importance of protective measures, especially for individuals with skin conditions.
- Early diagnosis based on the triad of neurological involvement, metabolic acidosis, and renal failure is critical for timely intervention.
- Prompt hemodialysis can significantly improve outcomes and prognosis in cases of severe ethylene glycol intoxication.
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