Patel Rutul, Mistry Anuja Mahesh, Mistry Chandrika M
Internal Medicine, Smt. Nathiba Hargovandas Lakhmichand (NHL) Municipal Medical College (NHLMMC), Ahmedabad, IND.
Pathology, Saham Hospital, Saham, OMN.
Cureus. 2020 Nov 17;12(11):e11521. doi: 10.7759/cureus.11521.
The differential diagnosis is broad when a patient presents with an altered mental status. Ethylene glycol poisoning, a life-threatening condition, can occur as an intentional self-harm attempt or unintentional consumption. It is metabolized in the liver by a series of enzymes, and the metabolites so formed are responsible for the majority of clinical effects. The diverse range of clinical effects includes central nervous system (CNS), gastrointestinal, cardiovascular system (CVS), pulmonary as well as renal effects. The evidence of metabolic acidosis, elevated anion gap, high osmolal gap, and calcium oxalate crystals in laboratory analysis strongly suggests ethylene glycol poisoning. The treatment traditionally consists of alcohol dehydrogenase inhibitors such as fomepizole or ethanol, and in some cases, hemodialysis is needed as well.
当患者出现精神状态改变时，鉴别诊断范围很广。乙二醇中毒是一种危及生命的状况，可因故意自残或意外摄入而发生。它在肝脏中通过一系列酶进行代谢，所形成的代谢产物是大多数临床效应的原因。临床效应的范围广泛，包括中枢神经系统（CNS）、胃肠道、心血管系统（CVS）、肺部以及肾脏效应。实验室分析中代谢性酸中毒、阴离子间隙升高、高渗摩尔间隙以及草酸钙晶体的证据强烈提示乙二醇中毒。传统的治疗方法包括使用酒精脱氢酶抑制剂，如甲吡唑或乙醇，在某些情况下还需要进行血液透析。
