ethylenglykoltoxicitet

Ethylenglykoltoxicitet describes the adverse health effects resulting from exposure to ethylene glycol. Ethylene glycol is a chemical commonly found in antifreeze and de-icing solutions. Ingestion is the primary route of significant toxicity.

Upon ingestion, ethylene glycol is metabolized in the liver into several toxic compounds, including glycolaldehyde, glycolic acid, glyoxylic acid, and oxalic acid. These metabolites are responsible for the observed toxic effects. The toxicity progresses through three distinct phases. The initial phase, occurring within 30 minutes to 12 hours after ingestion, is characterized by central nervous system depression, similar to alcohol intoxication, with symptoms like nausea, vomiting, ataxia, and confusion.

The second phase, typically between 12 and 24 hours post-ingestion, involves cardiopulmonary effects. This can include tachycardia, hypertension, hyperventilation, and potentially acute heart failure or pulmonary edema.

The third and most severe phase, usually occurring 24 to 72 hours after ingestion, is marked by renal failure. The metabolite oxalic acid can precipitate as calcium oxalate crystals in the renal tubules, leading to acute kidney injury. Other symptoms can include abdominal pain, flank pain, and decreased urine output.

Diagnosis is based on a history of exposure, clinical signs and symptoms, and laboratory findings, including elevated serum ethylene glycol levels and increased anion gap metabolic acidosis. Treatment is time-sensitive and involves supportive care, gastric decontamination if indicated, and administration of antidotes such as fomepizole or ethanol to inhibit the metabolism of ethylene glycol. Hemodialysis may also be necessary to remove ethylene glycol and its toxic metabolites from the body and correct metabolic abnormalities. Prompt medical attention is crucial to prevent severe morbidity and mortality.