Oxalate-induced encephalitic reactions to polyol-containing infusions during intensive care

Fifteen of 5800 neuropathologically examined brains showed oxalosis with an intense inflammatory reaction comparable to ethylene glycol intoxication. All patients had received intensive care therapy with infusions of high amounts of xylitol, sorbitol, mannitol, or fructose, mostly together with glucose. The encephalitic reaction induced by calcium oxalate crystals was manifested by clinical symptoms of cerebral damage. A genetically fixed polyol intolerance is hypothesized to explain polyol-induced oxaloses in brain, kidney, and partly also in myocardium.