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Case Report: Antifreeze Ingestion and Urine Fluorescence

This case report presents a patient with ethylene glycol intoxication from antifreeze ingestion. Ethylene glycol is an active ingredient in antifreeze, traditionally causing an anion gap metabolic acidosis with a high osmolality gap. In our emergency department, serum ethylene glycol is a send-out t...

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Detalles Bibliográficos
Autores principales: Varshavsky, Taras, Chin, Meigra Myers
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Department of Emergency Medicine, University of California, Irvine School of Medicine 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332530/
https://www.ncbi.nlm.nih.gov/pubmed/37465606
http://dx.doi.org/10.21980/J8G05T
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author Varshavsky, Taras
Chin, Meigra Myers
author_facet Varshavsky, Taras
Chin, Meigra Myers
author_sort Varshavsky, Taras
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description This case report presents a patient with ethylene glycol intoxication from antifreeze ingestion. Ethylene glycol is an active ingredient in antifreeze, traditionally causing an anion gap metabolic acidosis with a high osmolality gap. In our emergency department, serum ethylene glycol is a send-out test requiring hours for a result. The patient presented here had an initial acidotic venous blood gas with an elevated serum osmolality and osmolality gap, and a normal anion gap. Quick bedside analysis of the patient’s urine using ultraviolet fluorescence gave supportive evidence for the ingested substance while the serum ethylene glycol level was still pending. The patient was promptly treated with fomepizole, pyridoxine, thiamine, and sodium bicarbonate. Several hours after admission, the ethylene glycol level had resulted as 636 mg/dL. Due to the quick initiation of treatment, the patient had no complications or signs of end-organ damage during admission. TOPICS: Ethylene glycol, fomepizole, toxicology, ultraviolet fluorescence.
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spelling pubmed-103325302023-07-18 Case Report: Antifreeze Ingestion and Urine Fluorescence Varshavsky, Taras Chin, Meigra Myers J Educ Teach Emerg Med Visual EM This case report presents a patient with ethylene glycol intoxication from antifreeze ingestion. Ethylene glycol is an active ingredient in antifreeze, traditionally causing an anion gap metabolic acidosis with a high osmolality gap. In our emergency department, serum ethylene glycol is a send-out test requiring hours for a result. The patient presented here had an initial acidotic venous blood gas with an elevated serum osmolality and osmolality gap, and a normal anion gap. Quick bedside analysis of the patient’s urine using ultraviolet fluorescence gave supportive evidence for the ingested substance while the serum ethylene glycol level was still pending. The patient was promptly treated with fomepizole, pyridoxine, thiamine, and sodium bicarbonate. Several hours after admission, the ethylene glycol level had resulted as 636 mg/dL. Due to the quick initiation of treatment, the patient had no complications or signs of end-organ damage during admission. TOPICS: Ethylene glycol, fomepizole, toxicology, ultraviolet fluorescence. Department of Emergency Medicine, University of California, Irvine School of Medicine 2020-01-15 /pmc/articles/PMC10332530/ /pubmed/37465606 http://dx.doi.org/10.21980/J8G05T Text en © 2020 Varshavsky, et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/)
spellingShingle Visual EM
Varshavsky, Taras
Chin, Meigra Myers
Case Report: Antifreeze Ingestion and Urine Fluorescence
title Case Report: Antifreeze Ingestion and Urine Fluorescence
title_full Case Report: Antifreeze Ingestion and Urine Fluorescence
title_fullStr Case Report: Antifreeze Ingestion and Urine Fluorescence
title_full_unstemmed Case Report: Antifreeze Ingestion and Urine Fluorescence
title_short Case Report: Antifreeze Ingestion and Urine Fluorescence
title_sort case report: antifreeze ingestion and urine fluorescence
topic Visual EM
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332530/
https://www.ncbi.nlm.nih.gov/pubmed/37465606
http://dx.doi.org/10.21980/J8G05T
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