CHRONIC ETHYLENE-GLYCOL INTOXICATION

Over a six-week period a 60-year-old patient had several unexplained i ntoxication-like episodes. He finally had severe abdominal cramps with changes in the level of consciousness and oligoanuric renal failure ( creatinine 4.7 mg/dl). The history, marked metabolic acidosis (pH 7.15 , HCO3- 2.2 mmol/l, PCO2 6.6 mmHg) as well as raised anion residue (43 mmol/1) and the presence of oxalates in urine suggested poisoning by ethylene glycol contained in antifreeze liquid. Intensive haemodialysi s adequately eliminated ethylene glycol and its toxic metabolites (gly col aldehyde, glycolic acid). Renal function returned within 10 days, although the concentrating power of the kidney remained impaired for s everal weeks because of interstitial nephritis. The intoxication had b een caused by a defective heating-pipe system from which the antifreez e had leaked into the hot-water boiler (the patient had habitually pre pared hot drinks by using water from the hot-water tap). Gas chromatog raphy demonstrated an ethylene glycol concentration of 21 g per litre of water.