Wischnewski spots and ethylene glycol fatal poisoning: a case report

IF 1.2 4区医学 Q3 MEDICINE, LEGAL

Journal of forensic and legal medicine Pub Date : 2025-07-15 DOI:10.1016/j.jflm.2025.102930

Emanuele Capasso , Pascale Basilicata , Claudia Casella , Ilenia Bianchi , Andrea Ronchi , Gaetano Di Donna

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Abstract

We present the case of a woman who was found dead in a countryside 11 days after disappearing from home. At the examination of the scene of death a black plastic can of antifreeze fluid was found near the body.

The autopsy and complementary analysis allowed us to establish that the cause of death was an irreversible cardio-circulatory arrest caused by acute poisoning by the ingestion of ethylene glycol.

Moreover, the gastric mucosa showed numerous black hemorrhagic spots, histologically diagnosed to be “Wischnewski spots”.

Therefore, because most of the toxicity of ethylene glycol comes from its acid metabolites, we suggest that the presence of WSs in this case is strictly related to metabolic acidosis, supporting the thesis that acidosis plays a crucial role in the pathogenesis of WSs.

This is the first paper, to the best of our knowledge, that shows a correlation between ethylene glycol poisoning and Wischnewski spots.

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威氏斑与乙二醇致死性中毒1例报告

我们提出的情况下，一名妇女被发现死在农村从家里消失后11天。在对死亡现场的检查中，在尸体附近发现了一个装有防冻液的黑色塑料罐。尸检和补充分析使我们确定死因是由于摄入乙二醇急性中毒导致的不可逆转的心脏循环骤停。胃黏膜可见大量黑色出血点，组织学诊断为“Wischnewski斑”。因此，由于乙二醇的毒性大部分来自其酸性代谢物，我们认为本病例中WSs的存在与代谢性酸中毒密切相关，支持酸中毒在WSs发病机制中起关键作用的观点。据我们所知，这是第一篇显示乙二醇中毒和维什纽斯基斑之间存在关联的论文。

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

Journal of forensic and legal medicine MEDICINE, LEGAL-

CiteScore

2.70

自引率

6.70%

发文量

106

审稿时长

57 days

期刊介绍： The Journal of Forensic and Legal Medicine publishes topical articles on aspects of forensic and legal medicine. Specifically the Journal supports research that explores the medical principles of care and forensic assessment of individuals, whether adult or child, in contact with the judicial system. It is a fully peer-review hybrid journal with a broad international perspective. The Journal accepts submissions of original research, review articles, and pertinent case studies, editorials, and commentaries in relevant areas of Forensic and Legal Medicine, Context of Practice, and Education and Training. The Journal adheres to strict publication ethical guidelines, and actively supports a culture of inclusive and representative publication.