Clinical manifestations and renal pathology of ethylene glycol.

IF 1 Q4 UROLOGY & NEPHROLOGY

CEN Case Reports Pub Date : 2024-08-12 DOI:10.1007/s13730-024-00921-y

Shogo Taira, Shiori Tamayose, Tasuku Kikumura, Morikuni Nishihira

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引用次数: 0

Abstract

Ethylene glycol (EG) poisoning is a critical medical emergency often associated with suicide attempts in adults. EG is metabolized by alcohol dehydrogenase, leading to the formation of toxic metabolites that cause metabolic acidosis, renal failure, hypocalcemia, aciduria, and disorders of the central nervous and cardiovascular systems. Calcium oxalate, a metabolite of EG, contributes to acute tubular necrosis. Despite limited reports on human renal pathology, we present a case detailing renal pathology following EG ingestion. A 44-year-old male, admitted due to loss of consciousness, had ingested a lethal dose of EG. Blood tests indicated metabolic acidosis, while urinary examination revealed calcium oxalate crystals. Continuous renal replacement therapy corrected the acidosis; however, nephrogenic diabetes insipidus subsequently developed. A renal biopsy on day 31 revealed calcium oxalate crystal deposition and tubulointerstitial damage. Notably, various stages of crystal deposition, adherence, and degradation were observed. This case underscores the importance of considering EG poisoning in cases of unexplained metabolic acidosis and renal dysfunction, with renal biopsy serving as a valuable diagnostic tool. Understanding the renal effects of EG is essential for timely intervention and effective management of poisoning cases.

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乙二醇的临床表现和肾脏病理学。

乙二醇（EG）中毒是一种严重的医疗急症，通常与成年人企图自杀有关。乙二醇通过醇脱氢酶代谢，形成有毒代谢物，导致代谢性酸中毒、肾衰竭、低钙血症、酸中毒以及中枢神经和心血管系统紊乱。草酸钙是 EG 的代谢产物，会导致急性肾小管坏死。尽管有关人类肾脏病理学的报道有限，但我们还是介绍了一例详细的摄入 EG 后肾脏病理学病例。一名 44 岁的男性因意识丧失入院，他摄入了致命剂量的 EG。血液化验结果显示存在代谢性酸中毒，而尿液检查则发现了草酸钙结晶。持续的肾脏替代治疗纠正了酸中毒，但随后出现了肾源性糖尿病。第 31 天的肾活检发现草酸钙晶体沉积和肾小管间质损伤。值得注意的是，观察到晶体沉积、附着和降解的不同阶段。该病例强调了在出现不明原因的代谢性酸中毒和肾功能障碍时考虑 EG 中毒的重要性，肾活检是一种重要的诊断工具。了解 EG 对肾脏的影响对于及时干预和有效处理中毒病例至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CEN Case Reports UROLOGY & NEPHROLOGY-

CiteScore

1.90

自引率

0.00%

发文量

期刊介绍： Clinical and Experimental Nephrology (CEN) Case Reports is a peer-reviewed online-only journal, officially published biannually by the Japanese Society of Nephrology (JSN). The journal publishes original case reports in nephrology and related areas. The purpose of CEN Case Reports is to provide clinicians and researchers with a forum in which to disseminate their personal experience to a wide readership and to review interesting cases encountered by colleagues all over the world, from whom contributions are welcomed.

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