[Cigar-like oxalate crystals in ethylene glycol poisoning]

Coma with grave metabolic acidosis, increased anion and osmolal gap, oxalate crystals in urine sediment and increased ultrasound density of the renal parenchyma are essential clues to the diagnosis of ethylene glycol poisoning. Envelope-like dihydrate calcium oxalate crystals are usually found in the sediment of these patients. We describe a patient with needle and cigar-shaped monohydrate calcium oxalate crystals in urinary sediment, but no detectable ethylene glycol in blood tests taken upon arrival at hospital 12 hours after ingestion. The patient was treated with alkali and haemodialysis, and recovered without any sequelae. Monohydrate calcium oxalate crystals were an essential clue for diagnosis of ethylene glycol poisoning in this patient.