□ PICTURES IN CLINICAL MEDICINE □

Risk of Sweet ‘Ethylene Glycol’ Consumption

Takeshi Fujita 1, Norio Nakamura 1, Hiroyasu Hitomi 2 and Ken Okumura 2

Key words: ethylene glycol, kidney injury

(Intern Med 52: 409, 2013)

(DOI: 10.2169/internalmedicine.52.8884)

mg/dL; pH, 7.229; PaCO2, 23.3 Torr; and bicarbonate, 9.5

Picture.
A 75-year-old woman with cognitive impairment had
eaten the contents of an ice pack. The next day she vomited
and subsequently fainted. Laboratory data showed kidney in-
jury and severe metabolic acidosis: serum creatinine, 1.31
mEq/L. We suspected ethylene glycol poisoning and admin-
istered vitamin B1, B6, 10% ethanol and sodium bicarbon-
ate. Despite receiving this therapy, the patient showed epi-
sodes of disturbed consciousness and oliguria. She under-
went hemodialysis six times, following which her symptoms
improved.
Ethylene glycol is a sweet-tasting, viscous, nonvolatile,
colorless and hygroscopic liquid. Toxicity is caused by the
compound’s more toxic metabolites such as glycolic acid
and calcium oxalate. Metabolic acidosis, kidney injury and
central nervous system disorders are the major symptoms of
ethylene glycol poisoning. Ethanol inhibits the ethylene gly-
col metabolism. Hemodialysis has been shown to be highly
effective for the removal of both unmetabolized ethylene
glycol and glycolic acid.
The authors state that they have no Conflict of Interest (COI).

１
Department of Nephrology, Hirosaki University Graduate School of Medicine, Japan and ２Department of Cardiology, Hirosaki University
Graduate School of Medicine, Japan
Received for publication September 20, 2012; Accepted for publication September 24, 2012
Correspondence to Dr. Takeshi Fujita, fuji-ta@cc.hirosaki-u.ac.jp
Ⓒ 2013 The Japanese Society of Internal Medicine Journal Website: http://www.naika.or.jp/imonline/index.html

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