Acute ethylene glycol poisoning.

Ethylene glycol, a major constituent of antifreeze, is metabolized by alcohol dehydrogenase to glycoaldehyde, glycolate, glyoxylate, and oxalate. The metabolites of ethylene glycol cause severe metabolic acidosis and central nervous system, pulmonary, and renal damage. Ethanol competes with ethylene glycol as an alternate substrate of alcohol dehydrogenase. Two cases of ethylene glycol poisoning associated with serum concentrations of 59 and 150 mg/dl are reported. One patient was protected from the toxic effects of the metabolites because of concomitant ethanol ingestion. In patients with unexplained anion and osmol gaps, early diagnosis and therapy with ethanol and hemodialysis help prevent the toxic manifestations of ethylene glycol poisoning.