Investigation of crystallosis of the kidney by means of polarization, scanning, transmission and high-voltage electron microscopy.

This report deals with the investigation of renal crystallosis in the autopsy tissue of a fatal human case of ethylene glycol poisoning. A previously healthy 22-year-old man consumed about one liter of Prestone antifreeze, which contains 95% by weight of ethylene glycol. He died in coma 48 h later with clinical evidence of metabolic acidosis and renal shutdown. Postmortem histological examination showed abundant crystallosis of the renal tubules. Polarization microscopy demonstrated brilliant birefringence of the crystals. In addition to the tubular crystallosis, scanning electron microscopy showed crystalline particles within the glomeruli as well. Energy dispersive X-ray analysis of the crystals gave a strong calcium signal. The crystals were demonstrated by means of conventional and high-voltage electron microscopy. Electron diffraction gave several hexagonal patterns of calcium carbonate-calcite and a tetragonal pattern suggestive of calcium oxalate monohydrate. X-ray diffraction of the crystals separated from the kidney showed the presence of calcium carbonate and calcium oxalate monohydrate as the major constituents.