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Rapid Diagnosis of Ethylene Glycol Poisoning by Urine Microscopy
Hussam Mahmoud Sheta1, Issam Al-Najami2, Heidi Dahl Christensen3
1Department of Anaesthesia and Intensive Care, Lillebaelt Hospital, Kolding, Denmark.
Abstract:
BACKGROUND Ethylene glycol poisoning remains an important presentation to Emergency Departments. Quick diagnosis and treatment are essential to prevent renal failure and life-threating complications. CASE REPORT In this case report, we present a patient who was admitted unconscious to the hospital. Ethylene glycol poisoning was immediately suspected, because the patient had previously been hospitalized with similar symptoms after intake of antifreeze coolant. A urine sample was sent for microscopy and showed multiple calcium oxalate monohydrate (COM) crystals, which supported the clinical suspicion of ethylene glycol poisoning. The patient was treated with continuous intravenous ethyl alcohol infusion and hemodialysis. Two days after admission, the patient was awake and in clinical recovery. CONCLUSIONS Demonstration of COM crystals using microscopy of a urine sample adds valuable information supporting the clinical suspicion of ethylene glycol poisoning, and may serve as an easy, quick, and cheap method that can be performed in any emergency setting.
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