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Clinical Chemistry 44: 168-177, 1998;
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(Clinical Chemistry. 1998;44:168-177.)
© 1998 American Association for Clinical Chemistry, Inc.

Case Conference

Ethylene glycol poisoning: toxicokinetic and analytical factors affecting laboratory diagnosis

Anne F. Eder, Cindy M. McGrath, Yvonne G. Dowdy, John E. Tomaszewski, Frances M. Rosenberg1, Robert B. Wilson, Bryan A. Wolf, and Leslie M. Shaw1

Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19103.
1 Departments of Pathology and Laboratory Medicine, St. Paul's Hospital and University of British Columbia, Vancouver, BC, Canada V6Z 1Y6.

Ethylene glycol poisoning is an important toxicological problem in medical practice because early diagnosis and treatment can prevent considerable morbidity and mortality. When ingested in the form of antifreeze or other automotive products, ethylene glycol results in central nervous system depression, cardiopulmonary compromise, and renal insufficiency. Metabolism of ethylene glycol to organic acids is required for metabolic derangement and organ damage. Laboratory features of ethylene glycol poisoning include increased anion gap metabolic acidosis, increased osmolal gap, calcium oxalate crystalluria, and detectable ethylene glycol in serum. This Case Conference integrates discussion of the toxicokinetic and analytical variables that affect the laboratory diagnosis of ethylene glycol intoxication.




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