Andreelli F, Blin P, Codet M P, Fohrer P, Lambrey G, Massy Z
Service de Médecine Interne, Centre Hospitalier Général de Beauvais.
Nephrologie. 1993;14(5):221-5.
During the course of a case of ethylene glycol poisoning with ensuing oliguric renal failure despite early dialysis, we show the importance of early diagnosis of this intoxication in underlined. Characteristics of ethylene glycol poisoning are: metabolic acidosis with anion gap (without lactic acidosis or keto-acidosis) and high plasma osmolarity. Awaiting the result of blood and urinary toxic values, crystalluria, by typical needle monohydrate calcium oxalate crystals finding, evokes the diagnosis and permits to start a specific treatment. This treatment is based on: principles of intensive care, ethanol administration (or 4-methyl-pyrazole now available), also thiamine and pyridoxine administration and finally, dialysis therapy. We can hope, with early and intensive management of this poisoning, to prevent the renal failure, principal complication of ethylene glycol ingestion, which can lead to chronic renal failure. Therefore, crystalluria, an easy and specific diagnosis technic, is of great interest.
在一例乙二醇中毒病例中，尽管早期进行了透析，但仍出现了少尿性肾衰竭。我们强调了早期诊断这种中毒的重要性。乙二醇中毒的特征包括：伴有阴离子间隙的代谢性酸中毒（无乳酸性酸中毒或酮症酸中毒）以及高血浆渗透压。在等待血液和尿液毒物检测结果期间，通过发现典型的针状一水合草酸钙晶体而出现的结晶尿可提示诊断，并允许开始进行特异性治疗。这种治疗基于以下几点：重症监护原则、给予乙醇（或现在可用的4-甲基吡唑）、给予硫胺素和吡哆醇，最后进行透析治疗。通过对这种中毒进行早期和强化管理，我们有望预防乙二醇摄入的主要并发症——肾衰竭，而肾衰竭可能导致慢性肾衰竭。因此，结晶尿作为一种简单且特异性的诊断技术，具有重要意义。
