Ethylene Glycol Poisoning

Ethylene Glycol Poisoning is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Peak serum concentration in 1–4 hr
  • Half-life, 2.5–4.5 hr
  • <20% excreted unmetabolized by kidneys
  • Pathophysiology:
    • Metabolized by hepatic alcohol dehydrogenase and aldehyde dehydrogenase ultimately to oxalic acid
    • Results in aldehyde and acid metabolites
    • Directly toxic to kidney
    • Ethylene glycol metabolism:
      • Step 1 Ethylene glycol is converted by alcohol dehydrogenase to glycoaldehyde
      • Step 2 Glycoaldehyde is converted by aldehyde dehydrogenase to glycolic acid
      • Step 3 Glycolic acid is converted by lactate dehydrogenase to glyoxylic acid
      • Step 4 Glyoxylic acid is converted to oxalic acid

Etiology

  • Ethylene-glycol–containing products:
    • Antifreeze
    • Solvents
  • Min reported lethal dose is 30 mL of 100% ethylene glycol

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Basics

Description

  • Peak serum concentration in 1–4 hr
  • Half-life, 2.5–4.5 hr
  • <20% excreted unmetabolized by kidneys
  • Pathophysiology:
    • Metabolized by hepatic alcohol dehydrogenase and aldehyde dehydrogenase ultimately to oxalic acid
    • Results in aldehyde and acid metabolites
    • Directly toxic to kidney
    • Ethylene glycol metabolism:
      • Step 1 Ethylene glycol is converted by alcohol dehydrogenase to glycoaldehyde
      • Step 2 Glycoaldehyde is converted by aldehyde dehydrogenase to glycolic acid
      • Step 3 Glycolic acid is converted by lactate dehydrogenase to glyoxylic acid
      • Step 4 Glyoxylic acid is converted to oxalic acid

Etiology

  • Ethylene-glycol–containing products:
    • Antifreeze
    • Solvents
  • Min reported lethal dose is 30 mL of 100% ethylene glycol

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