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Ethylene glycol poisoning: A diagnostic challenge in a patient with persistent seizures and a severe metabolic acidosis

INTRODUCTION: Due to the nationwide lockdown to mitigate the spread of COVID-19 and subsequent alcohol ban in South Africa, several cases of toxic alcohol ingestion presented to our emergency unit. Many of these patients admitted to making home brews of alcohol while others simply use industrial tox...

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Autores principales: Smit, Almien, Lalloo, Vidya, Engelbrecht, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: African Federation for Emergency Medicine 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779712/
https://www.ncbi.nlm.nih.gov/pubmed/33425670
http://dx.doi.org/10.1016/j.afjem.2020.10.011
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author Smit, Almien
Lalloo, Vidya
Engelbrecht, Andreas
author_facet Smit, Almien
Lalloo, Vidya
Engelbrecht, Andreas
author_sort Smit, Almien
collection PubMed
description INTRODUCTION: Due to the nationwide lockdown to mitigate the spread of COVID-19 and subsequent alcohol ban in South Africa, several cases of toxic alcohol ingestion presented to our emergency unit. Many of these patients admitted to making home brews of alcohol while others simply use industrial toxic alcohols. The diagnosis of these poisonings is challenging as direct assays are not available in our setting. CASE REPORT: We present a case of presumed ethylene glycol poisoning that presented with persistent seizures and a high anion gap metabolic acidosis (HAGMA). DISCUSSION: A high index of suspicion for toxic alcohol poisoning should be maintained in patients presenting with an altered mental status, seizures and a HAGMA. Indirect markers such as clinical features and laboratory results can lead to the diagnosis when direct assays are unavailable.
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spelling pubmed-77797122021-01-08 Ethylene glycol poisoning: A diagnostic challenge in a patient with persistent seizures and a severe metabolic acidosis Smit, Almien Lalloo, Vidya Engelbrecht, Andreas Afr J Emerg Med Case Report INTRODUCTION: Due to the nationwide lockdown to mitigate the spread of COVID-19 and subsequent alcohol ban in South Africa, several cases of toxic alcohol ingestion presented to our emergency unit. Many of these patients admitted to making home brews of alcohol while others simply use industrial toxic alcohols. The diagnosis of these poisonings is challenging as direct assays are not available in our setting. CASE REPORT: We present a case of presumed ethylene glycol poisoning that presented with persistent seizures and a high anion gap metabolic acidosis (HAGMA). DISCUSSION: A high index of suspicion for toxic alcohol poisoning should be maintained in patients presenting with an altered mental status, seizures and a HAGMA. Indirect markers such as clinical features and laboratory results can lead to the diagnosis when direct assays are unavailable. African Federation for Emergency Medicine 2021-03 2020-11-06 /pmc/articles/PMC7779712/ /pubmed/33425670 http://dx.doi.org/10.1016/j.afjem.2020.10.011 Text en © 2018 Published by Elsevier Ltd. CC BY-NC-ND 4.0. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Smit, Almien
Lalloo, Vidya
Engelbrecht, Andreas
Ethylene glycol poisoning: A diagnostic challenge in a patient with persistent seizures and a severe metabolic acidosis
title Ethylene glycol poisoning: A diagnostic challenge in a patient with persistent seizures and a severe metabolic acidosis
title_full Ethylene glycol poisoning: A diagnostic challenge in a patient with persistent seizures and a severe metabolic acidosis
title_fullStr Ethylene glycol poisoning: A diagnostic challenge in a patient with persistent seizures and a severe metabolic acidosis
title_full_unstemmed Ethylene glycol poisoning: A diagnostic challenge in a patient with persistent seizures and a severe metabolic acidosis
title_short Ethylene glycol poisoning: A diagnostic challenge in a patient with persistent seizures and a severe metabolic acidosis
title_sort ethylene glycol poisoning: a diagnostic challenge in a patient with persistent seizures and a severe metabolic acidosis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779712/
https://www.ncbi.nlm.nih.gov/pubmed/33425670
http://dx.doi.org/10.1016/j.afjem.2020.10.011
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