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[Chronic ethylene glycol poisoning]

W Kaiser1, H G Steinmauer, G Biesenbach

  • 1II. Medizinische Abteilung, Allgemeines öffentliches Krankenhaus der Stadt, Linz.

Deutsche Medizinische Wochenschrift (1946)
|April 30, 1993
PubMed
Summary

A patient experienced unexplained intoxication due to ethylene glycol poisoning from antifreeze in his hot water. Intensive hemodialysis successfully removed the toxin, restoring kidney function but causing temporary kidney impairment.

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Area of Science:

  • Toxicology
  • Nephrology
  • Environmental Health

Background:

  • Ethylene glycol (EG) poisoning is a serious medical emergency.
  • Contaminated water sources can lead to accidental EG ingestion.
  • Early diagnosis and intervention are crucial for patient outcomes.

Observation:

  • A 60-year-old male presented with intoxication-like episodes, abdominal cramps, altered consciousness, and acute kidney injury.
  • Laboratory findings revealed severe metabolic acidosis, elevated anion gap, and urinary oxalates.
  • A history of consuming hot drinks prepared with tap water suggested a potential exposure source.

Findings:

  • Gas chromatography confirmed high ethylene glycol levels in tap water.
  • Intensive hemodialysis effectively cleared ethylene glycol and its toxic metabolites.

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  • The patient's renal function recovered within 10 days, with residual impairment of kidney concentrating ability due to interstitial nephritis.

    • Implications:

    • This case highlights the potential for severe toxicity from seemingly innocuous sources like contaminated household water.
    • Prompt recognition of metabolic acidosis and oxalate crystals is key for diagnosing EG poisoning.
    • Effective management involves rapid toxin elimination via hemodialysis and supportive care to prevent long-term organ damage.