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  Česky / Czech version Vnitř. Lék., 48, 2002, No. 11, p. 1054 - 1059
 
Diagnosis and Treatment of Ethylene Glycol Intoxication - Analysis of 20 Patients 
Mydlík M.1, Derzsiová K.1, Mizla P.1, Böör A.2, Mačingová E.3, Slosarčíková L.3 

1Nefrologická klinika Lekárskej fakulty UPJŠ a FN L. Pasteura, Košice, Slovenská republika, prednosta prof. MUDr. M. Mydlík, DrSc. 2Ústav patológie Lekárskej fakulty UPJŠ, Košice, Slovenská republika, prednosta prof. MUDr. A. Böör, CSc. 3Ústav súdneho lekárstva FN L. Pasteura, Košice, Slovenská republika, prednosta doc.MUDr. F. Longauer, CSc.
 


Summary:

       The paper presents a retrospective analysis of 20 patients with acute ethylene glycol intoxication who were treated from 1972 to 2001 in the Dialysis Centre of the IVth Medical Clinic and from 1997 at the L. Pasteur Nephrological Clinic of the Faculty Hospital and Šafarík Medical Faculty in Košice. The ethylene glycol intoxication was manifested by neurological symptoms, extreme metabolic acidosis, acute toxic hepatitis and acute renal failure. Laboratory examination revealed oxaluria in 17 patients and leukocytosis in all patients. Percutaneous renal biopsy was made for differential diagnostic or forensic reasons in the convalescent stage of acute renal failure in 6 patients. In the treatment of ethylene glycol intoxication the authors used ethyl alcohol as an antidote: in the first four patients administered by the i.v. route, in the remaining patients in dialyzation solution. Extreme metabolic acidosis improved in 15 patients after bicarbonate haemodialysis. Concomitant application of haemoperfusion over active charcoal during the first haemodialysis in four patients led to a potentiated effect on the uraemic syndrome. Conservative and extracorporeal elimination treatment of ethylene glycol intoxication succeeded in 16 patients (80 %). According to the authors´ experience early and fractionated application of bicarbonate haemodialysis with 100 mg % concentration of ethylalcohol in the dialysis solution is the method of choice in the treatment of ethylene glycol intoxication.

        Key words: Ethylene glycol intoxication - Metabolic acidosis - Ethylalcohol - Bicarbonate haemodialysis
       

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