Velez Larissa I, Shepherd Greene, Lee Yong Chan, Keyes Daniel C
Department of Surgery, Division of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390-8579, USA.
J Med Toxicol. 2007 Sep;3(3):125-8. doi: 10.1007/BF03160922.
Ethylene glycol is a widely used chemical that is capable of causing significant injury if ingested. Treatment for ethylene glycol poisoning typically includes basic supportive care, alcohol dehydrogenase inhibition, and hemodialysis. Recent data have suggested that hemodialysis may not be necessary for cases of ethylene glycol poisoning that can be treated with fomepizole as blocking therapy before acidosis or renal dysfunction develops.
A 33-year-old man presented to the emergency department 1 hour after drinking approximately 1/2 gallon of ethylene glycol antifreeze and an unknown quantity of beer. On arrival he was mildly inebriated but otherwise displayed no other features of ethylene glycol poisoning. Fomepizole therapy was initiated and initial laboratory studies later revealed an osmol gap of 157 mOsm and an ethylene glycol concentration of 706 mg/dL. Nephrology and toxicology services were consulted. Over the next 3 days, fomepizole therapy was continued while the patient's acid-base status and renal function were closely monitored. No evidence of acid-base abnormalities or renal impairment was ever observed and the patient was discharged to psychiatric care on the fourth hospital day.
This report describes the case of a patient who presented soon after a massive ingestion of ethylene glycol with very high serum concentrations. He was successfully treated using fomepizole and basic supportive care. Our patient developed neither renal insufficiency nor metabolic acidosis. His concomitant ethanol consumption, early presentation, and treatment likely contributed to his favorable outcome. This case report underscores the effectiveness of supportive care and fomepizole in the treatment of ethylene glycol poisoning.
乙二醇是一种广泛使用的化学品，若摄入可导致严重损伤。乙二醇中毒的治疗通常包括基本的支持性护理、抑制乙醇脱氢酶以及血液透析。最近的数据表明，对于在酸中毒或肾功能障碍发生之前可用甲吡唑作为阻断疗法治疗的乙二醇中毒病例，可能无需进行血液透析。
一名33岁男性在饮用约半加仑乙二醇防冻液和未知量啤酒1小时后前往急诊科就诊。到达时，他有轻度醉酒状态，但未表现出乙二醇中毒的其他特征。开始甲吡唑治疗，随后的初始实验室检查显示渗透压间隙为157 mOsm，乙二醇浓度为706 mg/dL。咨询了肾脏病学和毒理学专家。在接下来的3天里，继续进行甲吡唑治疗，同时密切监测患者的酸碱状态和肾功能。未观察到酸碱异常或肾功能损害的证据，患者在住院第四天出院接受精神科护理。
本报告描述了一名大量摄入乙二醇后不久就诊且血清浓度极高的患者的病例。他通过甲吡唑和基本支持性护理成功治愈。我们的患者既未出现肾功能不全也未出现代谢性酸中毒。他同时摄入乙醇、就诊及时以及接受治疗可能促成了良好的治疗结果。本病例报告强调了支持性护理和甲吡唑在治疗乙二醇中毒方面的有效性。
