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ID:129 Ethylene Glycol
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DescriptionConstituent of antifreeze which can be used as self harming agent. PLEASE CONTACT THE DUTY BIOCHEMIST BEFORE SENDING SAMPLES (Ext: 26922 or Bleep 2607 8.30am-17.00pm, out of hours please contact Consultant on call via switchboard).
IndicationInvestigation of suspected poisoning. Mild initial clinical effects resemble alcohol intoxication.
Additional InfoThe main toxic agent in both ethylene glycol and methanol poisoning is not the parent compound but the toxic metabolite produced by the action of alcohol dehydrogenase. Alcohol dehydrogenase converts ethylene glycol to glycoaldehyde which is then metabolised to glycolic acid which appears to be the principle cause of acidosis. The aldehydes (glycolic acid, glycoaldehyde and glyoxalate) may inhibit oxidative phosphorylation and respiration, oxalate causes renal damage and hypocalcaemia by binding to calcium to form calcium oxalate, crystals of which may appear in the urine. Therapy for both ethylene glycol and methanol poisoning is aimed at blocking the action of alcohol dehydrogenase by administration of ethanol, which is the preferred substrate, or Fomepizole, a competitive inhibitor of the enzyme. Dialysis may also be required to remove ethylene glycol and its metabolites and to provide renal support. The usual quoted toxic dose for an adult is 100 mL. Severe clinical effects are associated with concentrations > 500 mg/L. Symptoms are as follows: 30-60 mins post ingestion - Drowsiness, nausea and vomiting. In severe cases coma, severe anion gap acidosis and convulsions develop. 12-24 hours post ingestion tachycardia and tachypnoea occur. Mild hypertension has also been reported. Death may occur as a result of pulmonary oedema and CCF. 24-72 hours: oliguria, acute tubular necrosis and renal failure may occur.
Concurrent Testsna
Dietary Requirementsna
Interpretation

DepartmentBiochemistry
SampleBlood
TubeFluoride
Tube Picture
Collection ConditionsUrine and blood samples required.
Min. Vol5 mL
Freq.24/7

Ref. Range (Male)
Ref. Range (Female)
Ref. Range (Paed)
Ref. Range NotesEthylene is normally absent from blood and urine
Unitsmg/L
IP Acute TAT- Contact Laboratory
IP Routine TAT- Contact Laboratory
GP Acute TAT- Contact Laboratory
GP Routine TAT- Contact Laboratory
Turnround CommentChris Newton or Phil Whitfield:phil.whitfield@sth.nhs.uk

Originally edited by : DT. Review due on 14/05/2020 09:35:50. Published By Matthew Clifford on 14/05/2019 09:35:50.