Ethylene glycol exposure can lead to the development of renal failure due to the metabolic formation of calcium oxalate monohydrate (COM) crystals. Epub 2016 Sep 2. Massive ethylene glycol ingestion treated with fomepizole alone-a viable therapeutic option. Calcium Oxalate Crystals in Ethylene Glycol Toxicity. 2) Vitamins: Despite the lack of clinical evidence for benefit, there is little risk to administering either of these vitamin cofactors in ethylene glycol metabolism. In addition, hepatic damage due to calcium oxalate deposition has been Author information: (1)Johns Hopkins University, Baltimore, MD mhanoun1@jhmi.edu. It is most commonly encountered as automotive antifreeze.Diethylene glycol behaves similarly to ethylene glycol in an overdose. eCollection 2020 Aug 11. Pomara C, Fiore C, D'Errico S, Riezzo I, Fineschi V. Clin Toxicol (Phila). A Case of Poisoning by a Mixture of Methanol and Ethylene Glycol. The renal damage is closely linked to the degree of COM accumulation in the kidney and most likely results from a COM-induced injury to proximal tubule (PT) cells. Calcium oxalate crystals in acute ethylene glycol poisoning: a confocal laser scanning microscope study in a fatal case. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Features suggestive of ethylene glycol toxicity are HAGMA, high osmolar gap and oxalate crystals in urine. Ethylene glycol exposure can be extremely dangerous, with significant morbidity and mortality if left untreated. Ng PCY, Long BJ, Davis WT, Sessions DJ, Koyfman A. Intern Emerg Med. It is mainly used for two purposes, as a raw material in the manufacture of polyester fibers and for antifreeze formulations. Epub 2014 Aug 13.  |  Ethylene glycol poisoning should be suspected in an intoxicated patient with anion gap acidosis, hypocalcemia, urinary crystals, and nontoxic blood alcohol concentration. 2017 Dec;15(2):47-51. doi: 10.5049/EBP.2017.15.2.47. Hanouneh M(1), Chen TK(1). Ethylene glycol (IUPAC name: ethane-1,2-diol) is an organic compound with the formula (CH2OH)2. 2006;44(3):315-8. doi: 10.1080/15563650600588460. USA.gov. mitochondrial permeability transition, ethylene glycol poisoning, renal toxicity, oxalate crystals Ethylene glycol poisoning in humans and animals is characterized by a severe metabolic acidosis, cardiopulmonary complications, acute renal failure, … It is an odorless, colorless, sweet-tasting, viscous liquid. Ethylene glycol is a precursor for many polymers, eg. the precipitation of calcium by the oxalic acid metabolite of ethylene glycol. Epub 2018 Feb 9. A major commercial application of ethylene glycol is deicing fluid for aircrafts. NLM Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/, NLM Brent J, McMartin K, Phillips S, Burkhart KK, Donovan JW, Wells M, et al. • Ethylene glycol (EG) is a relatively common and potentially fatal intoxicant in small animals. 2009 Nov;47(9):859-69. doi: 10.3109/15563650903344793. The term “toxic alcohols” is a collective term that includes methanol, ethylene glycol, and isopropyl alcohol. 8(2):99-113. . This depression appears similar to ethanol intoxication, but without the characteristic odor of alcohol. A 72-year-old man was hospitalized when he was found stuporous to semicomatose, and despite massive bicarbonate therapy, died 36 hr after the admission. The role of calcium oxalate crystal deposition in cerebral vessels during ethylene glycol poisoning. Ethylene glycol is not volatile, and risk of inhalation exposure is minimal. Hontz D, Hensley J, Hiryak K, Lee J, Luchetta J, Torsiello M, Venditto M, Lucent D, Terzaghi W, Mencer D, Bommareddy A, VanWert AL.  |  PMID: 29020580 [Indexed for MEDLINE] MeSH terms National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Initial symptoms of ethylene glycol intoxication (0.5 to 12 hours after ingestion) are due to the direct toxicity of ethylene glycol. The toxic mechanism of ethylene glycol poisoning is mainly due to the metabolites of ethylene glycol. Fomepizole for the Seizures may occur due to a direct effect. Ethylene glycol (C2H6O2 Ethylene glycol is an odorless, colorless, sweet-tasting syrupy substance with a molecular weight of 62.07, freezing point of -13°C and a boiling point of 197.6°C. In my best Robert Duvall voice, “I love the smell of The previously reported gastrointestinal side effects of ethylene glycol toxicity are mostly nonspecific, including nausea, abdominal pain, and cramping. Initially it is metabolized by alcohol dehydro… 2020 Oct;48(5):377-384. doi: 10.1007/s00240-020-01202-w. Epub 2020 Jul 27. Related Articles A 73 … J Med Toxicol. 3.1.2 Environmental Effects The critical toxicity values presented in the SoS Report (Environment Canada and Health Canada 2000), namely the IC 25 of 3268 mg/L for the green alga Selenastrum capricornutum and the subchronic toxicity value of 4732 mg/L for the amphibian Xenopus laevis, still represent the most sensitive measurements of toxicity of ethylene glycol to aquatic organisms. However, these crystals shouldn't be used to dictate major management decisions. 2018 Apr;13(3):375-383. doi: 10.1007/s11739-018-1799-9. Fomepizole is a … 2020 Jul 27;5(31):19469-19477. doi: 10.1021/acsomega.0c01655. Since calcium oxalate monohydrate crystals are transported intracellularly by kidney cells, the renal toxicity of ethylene glycol may result from inhibition of mitochondrial respiratory function in proximal tubular cells by calcium oxalate monohydrate crystals. Ethylene glycol is converted by the liver into toxic byproducts that are damaging to the kidneys. Please enable it to take advantage of the complete set of features! 1997 Sep-Oct;15(5):653-67. doi: 10.1016/s0736-4679(97)00145-5. 1994 Mar-Apr.  |  Ethylene glycol is a colorless and odorless dihydroxyl alcohol with a myriad of uses, most commonly found in antifreeze. Histology of the resected colon revealed polarizable polyhedral crystals suggestive of oxalate deposition. An integrated perspective on the developmental toxicity of ethylene glycol. ACS Omega. Rejuvenation Res. Clin Exp Nephrol. We describe a patient who developed acute colonic ischemia following ethylene glycol intoxication. 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