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Ethylene Glycol
Ethylene Glycol [chemical/ingredient]

Images

WIKIDATA, CC BY-SA 3.0
WIKIDATA, Public Domain
WIKIDATA, Public Domain
WIKIDATA, Public Domain
WIKIDATA, Public Domain

Presentation

Serum calcium on presentation was compared to blood gas pH on presentation as well as presentation serum bicarbonate. [ncbi.nlm.nih.gov]

Entire Body System

  • Gastric Lavage

    Lavage is not effective Activated Charcoal is not effective [fpnotebook.com]

    There is no role for activated charcoal, cathartics or gastric lavage in ethylene glycol intoxication. Alcoholics and patients likely to be malnourished should be given thiamine and pyridoxine. [renalandurologynews.com]

    Treatment included gastric lavage, charcoal, and intravenous ethanol. The serum ethanol concentration was maintained between 17 and 22 mmol/L (76–103 mg/dL). [clinchem.aaccjnls.org]

    Ethylene glycol is rapidly absorbed from the stomach, making treatment with gastric lavage and syrup of ipecac ineffective. 3, 6 Likewise, it requires large amounts of activated charcoal to bind relatively small amounts of ethylene glycol, and the therapeutic [aafp.org]

Respiratoric

  • Tachypnea

    As the high osmolar gap resolves, HAGMA (high anion gap metabolic acidosis) and hypocalcemia occur, with clinical manifestations that include dyspnoea, tachypnea, tachycardia, hypertension, shock, coma, tetany, seizures and death. [lifeinthefastlane.com]

    Initially, patients may be asymptomatic, but ethylene glycol is rapidly absorbed (within 1 to 4 hours), and altered mental status and tachypnea then begin to appear as the ethylene glycol is successively metabolized to very toxic compounds. [emedicine.com]

    Cardiopulmonary manifestations may be observed 12–24 h after ingestion and may include tachypnea, tachycardia, hypertension, pulmonary edema, and congestive heart failure. [clinchem.aaccjnls.org]

Gastrointestinal

  • Vomiting

    The authors report a patient who had recurrent episodes characterized by nausea, vomiting, and signs of dehydration necessitating admission to the hospital. At each admission, he was found to have lactic acidosis. [ncbi.nlm.nih.gov]

    Exposure Routes inhalation, ingestion, skin and/or eye contact Symptoms irritation eyes, skin, nose, throat; nausea, vomiting, abdominal pain, lassitude (weakness, exhaustion); dizziness, stupor, convulsions, central nervous system depression; skin sensitization [cdc.gov]

    If swallowed, give water or milk to drink and induce vomiting. Never give anything by mouth to an unconscious person. In all cases call a physician. Product Use: Laboratory Reagent. [web.archive.org]

    Ingestion: Induce vomiting immediately as directed by medical personnel. Never give anything by mouth to an unconscious person. Get medical attention. Skin Contact: Remove any contaminated clothing. [hazard.com]

    Do not try to induce vomiting. EG can cause nausea, vomiting, slurred speech, dizziness, unsteady gait, and abdominal pain. A person who is poisoned with EG may appear drunk. They may also have a sweet aromatic odor to their breath. [acmt.net]

  • Nausea

    The previously reported gastrointestinal side effects of ethylene glycol toxicity are mostly nonspecific, including nausea, abdominal pain, and cramping. In addition, hepatic damage due to calcium oxalate deposition has been reported. [ncbi.nlm.nih.gov]

    Exposure Routes inhalation, ingestion, skin and/or eye contact Symptoms irritation eyes, skin, nose, throat; nausea, vomiting, abdominal pain, lassitude (weakness, exhaustion); dizziness, stupor, convulsions, central nervous system depression; skin sensitization [cdc.gov]

    EG can cause nausea, vomiting, slurred speech, dizziness, unsteady gait, and abdominal pain. A person who is poisoned with EG may appear drunk. They may also have a sweet aromatic odor to their breath. [acmt.net]

Cardiovascular

  • Tachycardia

    His examination was significant for confusion, acetone odour, tachycardia and tachypnoea. Further blood tests revealed an anion gap of 31 mEq/L, serum osmolal gap of 34 mOsm/kg, and creatinine 3.6 mg/dL. [ncbi.nlm.nih.gov]

    As the high osmolar gap resolves, HAGMA (high anion gap metabolic acidosis) and hypocalcemia occur, with clinical manifestations that include dyspnoea, tachypnea, tachycardia, hypertension, shock, coma, tetany, seizures and death. [lifeinthefastlane.com]

    Mild to moderate, Stage 2: Increased heart rate (tachycardia); abnormal or disordered heart rhythms (dysrhythmia); increased blood pressure (hypertension); and build-up of toxic breakdown products in the blood stream (metabolic acidosis), resulting in [cdc.gov]

    Hypertension, tachycardia, and cardiac failure may ensue. Pneumonitis, pulmonary edema, and adult respiratory distress syndrome have also been reported. 3, 9 Renal involvement may become apparent within 24 to 72 hours after ingestion. [aafp.org]

    Cardiopulmonary manifestations may be observed 12–24 h after ingestion and may include tachypnea, tachycardia, hypertension, pulmonary edema, and congestive heart failure. [clinchem.aaccjnls.org]

Urogenital

  • Oliguria

    Recovery after prolonged oliguria due to ethylene glycol intoxication. Arch Intern Med 1970 ; 125 : 1059 -1062. ↵ Gutman RA, Hamon CB, Striker GE. Recovery after prolonged oliguria. [clinchem.aaccjnls.org]

Neurologic

  • Confusion

    A 29-year-old male presented at the emergency department of our hospital in a confused state. He had a history of psychoses and substance abuse. Physical examination revealed hyperventilation and abdominal tenderness. [ncbi.nlm.nih.gov]

    Gimbanjang/iStock/GettyImages Sometimes two compounds have similar-sounding names but would be disastrous if confused. Polyethylene glycol and ethylene glycol are two of these substances. [sciencing.com]

    […] acidemia may be confused with ethylene glycol in the gas chromatographic assay. [mayomedicallaboratories.com]

  • Seizure

    Observed symptoms of intoxication were seizures, respiratory depression, arrhythmias and hypotonia. All died in hospital after failed attempts at resuscitation, one person did so after an 11h dialysis treatment. [ncbi.nlm.nih.gov]

    Severe, Stage 1: Decreased reflex responses, seizures, loss of consciousness, and coma. [cdc.gov]

    Seizures — control with IV benzodiazepines, and intubate and ventilate as required (see above). [lifeinthefastlane.com]

    Diagnose Multiple Systems Atrophy based on the 2008 criteria Arteriovenous Malformation Coma/Level of Consciousness Demyelinating Disease Dermatome Map Functional Outcome Head & Neck Trauma Headache Intracerebral Hemorrhage Ischemic Stroke Neurophysiology Seizure [qxmd.com]

    About 3-12 hours after ingestion, a person can develop seizures, tremors, rapid shallow breathing, and worsening sleepiness that may progress to coma and death. Kidney failure is a well-known complication of EG poisoning. [acmt.net]

  • Altered Mental Status

    This case demonstrates the importance of early recognition of potential ingestions in patients with altered mental status and supportive laboratory findings. [ncbi.nlm.nih.gov]

    mental status after a fall at home. [nejm.org]

    […] in mental status, hypoglycemia, or respiratory depression. [emedicine.medscape.com]

    Ethylene glycol itself may cause some alteration of mental status but it is a relatively nontoxic compound before it is metabolized. The metabolites cause the distinctive toxicity associated with this compound. [emedicine.com]

  • Stupor

    Exposure Routes inhalation, ingestion, skin and/or eye contact Symptoms irritation eyes, skin, nose, throat; nausea, vomiting, abdominal pain, lassitude (weakness, exhaustion); dizziness, stupor, convulsions, central nervous system depression; skin sensitization [cdc.gov]

    Symptoms may include nausea, vomiting, convulsions, stupor (decreased level of alertness), or even coma. [medlineplus.gov]

    Ingestion causes stupor or coma, sometimes leading to fatal kidney injury. [cameochemicals.noaa.gov]

    Ingestion: Initial symptoms in massive dosage parallel alcohol intoxication, progressing to CNS depression, vomiting, headache, rapid respiratory and heart rate, lowered blood pressure, stupor, collapse, and unconsciousness with convulsions. [web.archive.org]

  • Headache

    […] the 2017 criteria Diagnosis of Multiple System Atrophy (MSA) Diagnose Multiple Systems Atrophy based on the 2008 criteria Arteriovenous Malformation Coma/Level of Consciousness Demyelinating Disease Dermatome Map Functional Outcome Head & Neck Trauma Headache [qxmd.com]

    Exposure to vapors over an extended time period has caused throat irritation and headache. May cause nausea, vomiting, dizziness and drowsiness. Pulmonary edema and central nervous system depression may also develop. [web.archive.org]

    Chronic or repeated exposure to ethylene glycol may lead to: irritation of the throat, mild headache, low backache, loss of consciousness, and nystagmus. These will resolve if the source of exposure is removed. [cdc.gov]

    Human systemic effects by ingestion and inhalation: eye lachrymation, general anesthesia, headache, cough, respiratory stimulation, nausea or vomiting, pulmonary, kidney, and liver changes. [chemicalbook.com]

Workup

Workup for his neutrophilia excluded infectious and malignant causes. An elevated leukocyte alkaline phosphatase (LAP) level confirmed a leukemoid response, and the neutrophila resolved. [ncbi.nlm.nih.gov]

Second, the patient has a definite history of recent ethylene glycol ingestion (especially if the osmolal gap is 10 mOsm/L or more, though patients with potentially toxic ethylene glycol ingestions may have an apparently normal osmolar gap; see Workup [emedicine.medscape.com]

Treatment

Treatment with fomepizole continued until the patient's plasma ethylene glycol concentration was 16 mg/dL. His metabolic acidosis quickly resolved, he had no adverse reactions to the treatment, and his renal function remained normal. [ncbi.nlm.nih.gov]

Prognosis

Ethylene glycol intoxication is one of the most serious acute poisonings with very uncertain prognosis with regard to both recovery and survival. [ncbi.nlm.nih.gov]

Treatment and prognosis With prompt and appropriate therapy, ethylene glycol toxicity can be minimized. Treatment is primarily with haemodialysis, administration of bicarbonate (to counteract metabolic acidosis), and fomepizole 1. [radiopaedia.org]

Although the test is not a good indicator of prognosis, a documented level above 20 mg per dL (3 mmol per L) is an indication for treatment with fomepizole (Antizol). 4 The excretion of calcium oxalate crystals in the urine is a finding in approximately [aafp.org]

Epidemiology

Epidemiology Frequency United States Ethylene glycol is a relatively common cause of overdose in US emergency departments. [emedicine.com]

Pathophysiology

We briefly review the pathophysiology and current treatment strategies for ethylene glycol intoxication, and discuss issues surrounding enteral versus parenteral ethanol administration. [ncbi.nlm.nih.gov]

Useful For Suggests clinical disorders or settings where the test may be helpful Confirming and monitoring ethylene glycol toxicity Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory [mayomedicallaboratories.com]

Pathophysiology [2] Like the other toxic alcohols mentioned above, ethylene glycol is a parent compound that exerts most of its toxicity by conversion to metabolites. [emedicine.com]

Prevention

These results suggest that caffeic acid (1) can be further investigated for the prevention, and treatment of kidney stones. [ncbi.nlm.nih.gov]

[…] lassitude (weakness, exhaustion); dizziness, stupor, convulsions, central nervous system depression; skin sensitization Target Organs Eyes, skin, respiratory system, central nervous system Personal Protection/Sanitation ( See protection codes ) Skin: Prevent [cdc.gov]

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