Acute ethylene glycol intoxication. Part I. Pathophysiology and clinical stages

Acute ethylene glycol (EG) intoxication is a life-threatening medical emerg ency characterized by hyperosmolality, profound high anion gap metabolic ac idosis, and oliguric or anuric renal failure. Toxic effects and associated clinical signs of this syndrome are caused by both EG and its metabolites, particularly glycolate; however, there is confusion in the medical (human a nd veterinary) literature regarding the various metabolites of EG and their putative roles in the pathophysiology of this devastating syndrome.