Fatal ethylene glycol intoxication1

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The authors describe a 27-year-old man with signs of acute ethylene glycol intoxication, including coma, absent pupillary reflexes, hypotonia, and hyporeflexia, plus laboratory evidence of a high-anion-gap metabolic acidosis, an osmolal gap, calcium oxalate monohydrate crystalluria, and elevated serum ethylene glycol levels. He failed to respond to sodium bicarbonate and ethanol therapy and died immediately before hemodialysis. The diagnosis, clinical presentation, pathophysiology, and treatment of acute ethylene glycol intoxication are reviewed.



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