Lovrić Mila, Granić Paula, Cubrilo-Turek Mirjana, Lalić Zdenka, Sertić Jadranka
Clinical Institute of Laboratory Diagnosis, Zagreb University Hospital Center, Kispatićeva 12, Zagreb, Croatia.
Forensic Sci Int. 2007 Aug 6;170(2-3):213-5. doi: 10.1016/j.forsciint.2007.03.025. Epub 2007 Jul 16.
A 40-year-old man was admitted to the emergency department after a suicide attempt. The patient was found at home unconscious, with an open bottle of antifreeze near him. The patient was in a coma on admission, but neurological examination excluded intracranial changes. Results of initial urine and serum toxicological screening tests were negative. Laboratory values indicated metabolic acidosis, leukocytosis, urinalysis revealed hematuria and unrecognized crystals. Osmolality and osmol gap were not determined on patient admission. Treatment with ethanol as an antidote and hemodialysis were started because of metabolic acidosis, anamnestic data and clinical status of the patient, and subsequently led to improvement of his condition. Further toxicological analyses of glycolic and oxalic acids in serum and urine samples were performed by ion-chromatography (IC) method and showed high values in spot urine and serum ultrafiltrate at admission, but during therapy the values progressively decreased. Treatment of poisoned patient for 3 weeks resulted in complete recovery.
一名40岁男子在自杀未遂后被送往急诊科。患者在家中被发现昏迷，身边有一瓶打开的防冻液。患者入院时处于昏迷状态，但神经系统检查排除了颅内病变。初步尿液和血清毒理学筛查结果为阴性。实验室检查结果显示代谢性酸中毒、白细胞增多，尿液分析显示血尿和未识别的晶体。入院时未测定渗透压和渗透压间隙。由于代谢性酸中毒、患者既往史和临床状况，开始用乙醇作为解毒剂并进行血液透析治疗，随后患者病情有所改善。通过离子色谱法（IC）对血清和尿液样本中的乙醇酸和草酸进行了进一步的毒理学分析，结果显示入院时即时尿和血清超滤液中的含量较高，但在治疗过程中这些值逐渐下降。对中毒患者进行3周治疗后完全康复。
