Ethylene glycol intoxication: evaluation of kinetics and crystalluria

Am J Med. 1988 Jan;84(1):145-52. doi: 10.1016/0002-9343(88)90024-1.

Abstract

Ethylene glycol and glycolate kinetics were studied in two cases of ethylene glycol intoxication with maximal ethylene glycol/glycolate concentrations of 40.9/26.8 and 56.4/22.4 mmol/liter, respectively. Both patients survived, but with prolonged renal failure, upon treatment with bicarbonate, ethanol, and hemodialysis. Glycolic acid was the major cause of the metabolic acidosis in both cases; lactate levels were only slightly elevated. Kinetic calculations showed that both ethylene glycol and glycolate were distributed in total body water with plasma half-lives of 8.4 and 7.0 hours, respectively. The half-life of ethylene glycol was increased more than 10-fold by ethanol treatment alone. Calcium oxalate monohydrate crystalluria was dominant in both cases, but in one was preceded by a short period with mainly dihydrate excretion; crystalluria was not present upon admission. Repetitive urine microscopy in search of needle- or envelope-shaped crystals should be performed when ethylene glycol intoxication is suspected.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acidosis / chemically induced
  • Acute Kidney Injury / chemically induced
  • Adult
  • Ethylene Glycol
  • Ethylene Glycols / pharmacokinetics
  • Ethylene Glycols / poisoning*
  • Female
  • Glycolates / pharmacokinetics
  • Half-Life
  • Humans
  • Suicide, Attempted
  • Time Factors
  • Urine / analysis

Substances

  • Ethylene Glycols
  • Glycolates
  • Ethylene Glycol