Ethylene Glycol, Serum or Plasma

Ethylene glycol is a colorless, odorless, sweet tasting compound used commercially in antifreeze. It has been utilized in suicide attempts, as a substitute for ethanol and in accidental poisonings in both children and domestic pets. 100 mL is lethal; rapid treatment can prevent damage. Half-life is three to five hours. Toxicity is manifested by CNS depression (1 to 12 hours after ingestion), cardiopulmonary symptoms (12 to 24 hours after ingestion), and renal damage (24 to 72 hours after ingestion). Oxalate is a minor metabolite of ethylene glycol and crystals are commonly seen in urine. In addition to blood levels of ethylene glycol, hypocalcemia, elevated anion gap, metabolic acidosis, and osmolal gap elevation are observed. Precaution: Toxicity may be manifested without osmolal gap changes and osmolal and anion gap increases can be present with very low levels of ethylene glycol.