CONCLUSIONS Demonstration of COM crystals using microscopy of a urine sample adds valuable information supporting the clinical suspicion of ethylene glycol poisoning, and may serve as an easy, quick, and cheap method that can be performed in any emergency setting. Ethylene glycol is found in many household products and is a common toxic ingestion. Massive calcium oxalate … Chemical properties. The classic laboratory profile of ethylene glycol ingestion is an early osmolar gap (the ethylene glycol serves as an unmeasured osmole) that disappears as an anion gap metabolic acidosis develops (as the ethylene glycol is converted into its acidic derivatives). USA.gov. Clinical Toxicology, 2008. Ethylene glycol is found in many household products and is a common toxic ingestion. Monohydrate crystals are the predominant form of oxalate crystal seen with ethylene glycol poisoning. Urine sediments of dogs with experimentally induced ethylene glycol poisoning were examined by light microscopy and X-ray diffraction. 3, pp. Ethylene glycol poisoning was immediately suspected, because the patient had previously been hospitalized with similar symptoms after intake of antifreeze coolant. [1] Early symptoms include intoxication, vomiting and abdominal pain. Download PDF. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. NLM The true toxicity of ethylene glycol is mediated by its metabolites, which are responsible for the increased anion gap metabolic acidosis, renal tubular damage, and crystalluria seen later in ingestions. Triple phosphate crystals or struvite stones: Form in alkaline urine and composed of magnesium, ammonium, and phosphate. 1994 Feb 10;114(4):435-6. Calcium oxalate is a combination of calcium ions and the conjugate base of oxalic acid, the oxalate anion. Acute ingestions present with altered sensorium and an osmolal gap. The histologic diagnosis of acute renal failure secondary to ethylene glycol poisoning depends on the recognitions of the changes of acute tubular damage in association with calcium oxalate crystals deposition within the tubular epithelial cells and the widespread necrosis of the tubular epithelium in the proximal tubules. This site needs JavaScript to work properly. Keywords: Acidosis; Ethylene Glycol, Hyperglycemia, Poisoning; Renal Insufficiency Ethylene Glycol Poisoning; an Unusual Cause of Hyperglycemia: A Case Report 55 after 24 to 48 hours of EG ingestion. Lumlertgul N, Siribamrungwong M, Jaber BL, Susantitaphong P. Kidney Int Rep. 2018 Jul 29;3(6):1363-1372. doi: 10.1016/j.ekir.2018.07.020. [1] Long term outcomes may include kidney failure and brain damage. Calcium Phosphate: Can have different morphologies depending on state of hydration. [1] Later symptoms may include a decreased level of consciousness, headache, and seizures.  |  -, McQuade DJ, Dargan PI, Wood DM. This can be highly suggestive of ethylene glycol poisoning under the right circumstances. 2017;13:153–57. Any alcohol when consumed in enough of a quantity can be toxic; however, we will not discuss ethanol as it is not one of the classic “toxic alcohols.” These typically include methanol, ethylene glycol, propylene glycol, and isopropanol (isopropyl alcohol). eCollection 2018 Nov. Sheta HM, Al-Najami I, Christensen HD, Madsen JS. Ethylene glycol poisoning was immediately suspected, because the patient had previously been hospitalized with similar symptoms after intake of antifreeze coolant. A urine sample was sent for microscopy and showed multiple calcium oxalate monohydrate (COM) crystals, which supported the clinical suspicion of ethylene glycol poisoning. 231-234. 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