FATAL CHRONIC OXALOSIS AFTER SUBLETHAL ET HYLENE-GLYCOL POISONING

A 36-year-old man known as chronic alcohol abuser presently suffered f rom arthralgia and showed bilateral petriefied kidneys by sonography a nd computed tomography. Because of an unclear renal failure a kidney b iopsy was performed and presented typical chronic renal oxalosis with massive oxalate crystal deposits, tubular atrophy and interstitital fi brosis. Since the man had never shown signs of hyperoxaluria in his li fe before, a secondary oxalosis was supposed. The subsequently prompte d exploration established a three to four times abuse of rocket fuel w ith cola lemonade 12 years before during the patient's army time as a marine soldier. Such fuels contain ethylene glycol (glysantin) as anti freeze commonly known to cause in toxic doses acute renal tubular necr osis with hyperoxaluria. The presented case, however, suggests a rare sublethal ethylene glycol poisoning with initial renal tubular damage, oxalate crystal deposition and subsequent chronic interstitial oxalat e nephritis with tubular atrophy, interstitial fibrosis and chronic re nal failure. Undergoing chronic hemodialysis,the patient died 5 months after the kidney biopsy diagnosis by a cute heart failure. At autopsy , progressed chronic renal oxalosis could be confirmed. Decompensated oxalate cardiomyopathy with disseminated myocardial oxalate crystal de posits caused acute heart failure promoted by myocardial hypertrophy i n renal hypertension.