Schwerk Nicolaus, Desel Herbert, Schulz Manuela, Schwerk Christina, Kiess Wieland, Siekmeyer Werner
Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany.
Acta Paediatr. 2007 Mar;96(3):461-3. doi: 10.1111/j.1651-2227.2007.00115.x.
Severe poisoning with ethylene glycol, often used as antifreeze, is a rare, life-threatening event. Neurological symptoms are accompanied by metabolic acidosis with elevated anion gap and osmotic gap. We report on a 7-year-old boy suffering from severe ethylene glycol intoxication. Early diagnosis based on typical clinical signs and rapid initiation of specific therapy with ethanol resulted in complete and rapid recovery without haemodialysis becoming necessary. While one laboratory initially had not been able to detect ethylene glycol in the patient's blood, an ethylene glycol serum level of 3900 mg/L was measured by a second laboratory, the highest value ever reported in the scientific literature for paediatric cases. Ethylene glycol poisoning is verified by quantitative glycol analysis in serum, but only few laboratories are able to perform this investigation in emergency cases. Therefore, in the beginning diagnosis has to be based on patient's history and clinical signs. Every substantial suspicion of ethylene glycol poisoning has to be treated with an antidote (fomepizole or ethanol) immediately.
Ethylene glycol poisoning is rare in the paediatric age group in our series of glycol poisonings. One should keep in mind, that early diagnosis and treatment due to clinical signs is important and haemodialysis usually is not necessary.
乙二醇严重中毒，乙二醇常用作防冻剂，是一种罕见的、危及生命的事件。神经症状伴有阴离子间隙和渗透压间隙升高的代谢性酸中毒。我们报告一例7岁男孩严重乙二醇中毒病例。基于典型临床症状的早期诊断以及迅速开始用乙醇进行特异性治疗，使患儿完全且迅速康复，无需进行血液透析。虽然最初有一个实验室未能在患儿血液中检测到乙二醇，但另一个实验室测得血清乙二醇水平为3900mg/L，这是科学文献中报道的儿科病例中的最高值。血清中乙二醇的定量分析可证实乙二醇中毒，但只有少数实验室能够在紧急情况下进行此项检测。因此，一开始诊断必须基于患者病史和临床症状。每一例高度怀疑乙二醇中毒的病例都必须立即用解毒剂（甲吡唑或乙醇）进行治疗。
在我们的一系列乙二醇中毒病例中，乙二醇中毒在儿科年龄组中较为罕见。应牢记，基于临床症状的早期诊断和治疗很重要，且通常无需进行血液透析。
