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Clin Toxicol (Phila) 2017 Dec;55(10):1072-1252. Note in cats, no polydipsia so this could be due to dehydration. Anion and osmolar gaps are often used for the diagnosis and exclusion of these sometimes subtle overdoses. Toxicity from this substance may be encountered in the military and civilian populations. However, these tests are not specific for ethylene glycol toxicity, and by the time these blood tests show evidence of kidney failure, the prognosis is grave to poor (since it is too late to treat with the antidote). Copyright © 2020, StatPearls Publishing LLC. • Serum osmolality (N = 280-310 mOsm/kg) – Starts increasing 1h post ingestion; increase parallel serum EG concentrations. Trends in toxic alcohol exposures in the United States from 2000 to 2013: a focus on the use of antidotes and extracorporeal treatments. Hodgman M, Marraffa JM, Wojcik S, Grant W. Serum Calcium Concentration in Ethylene Glycol Poisoning. Seizures may occur due to a direct effect. Aldehyde metabolites lead to cytotoxicity, calcium oxalate crystal deposition and secondary cerebral edema. Toxicity level is one of the primary differences between propylene glycol and ethylene glycol antifreeze. Metabolites are cytotoxic to proximal tubular cells, resulting in the deposition of these calcium oxalate crystals (monohydrate) within the lumen of kidney tubules, thereby causing interstitial edema and their subsequent urinary excretion. • All toxic causes of increased anion gap metabolic acidosis – methanol, salicylates, alcoholic ketoacidosis, lacticacidosis; non-toxic causes – diabetic ketoacidosis, lactic acidosis (any form), • Other chemicals with similar clinical signs – ataxia and CNS depression, Excellent in dogs treated 5h post ingestion with 4-MP, Good with cats treated 3h following ingestion, Cecil F. Brownie, DVM, PhD, DABVT, DABT, DABFE, DABFM, FACFE. Ethylene glycol toxicity associated with ischemia, perforation, and colonic oxalate crystal deposition. -, White NC, Litovitz T, Benson BE, Horowitz BZ, Marr-Lyon L, White MK. Since the metabolites rather than parent compound (ethylene glycol), are the primary toxins, toxicity is best characterized as lethal synthesis. This procedure cross reacts with propylene glycol and/or glycerol, therefore the possibility of false positive results. Notes Component of antifreeze, automobile coolants, de-icing agents, industrial solvents and hydraulic brake fluid. Glycol is an aliphatic diol. The systemic toxicity of the ethylene-based glycol ethers is mediated by their metabolism to the corresponding alkoxyacetic acids. COVID-19: LOW risk Start test. In cats, the kidneys become enlarged and painful on palpation. Ethylene Glycol is lethal when >1 ml/kg is ingested therefore any deliberate ingestion need prompt intervention. Ethylene glycol toxicity is a type of toxic leukoencephalopathy. In view of recent findings with other chemically related glycol ethers, particular attention has been … Chemical Product and Company Identification Product Name : Mono Ethylene glycol Catalog Codes : SLE1072 CAS# : 107 -21 -1 RTECS : KW2975000 TSCA : TSCA 8(b) inventory: Ethylene glycol CI# : Not available. Antidotes for poisoning by alcohols that form toxic metabolites. Early empiric ethanol therapy and consideration of dialysis are recommended for those patients with such a presentation without evidence of abnormal levels of ketones, lactate, salicylate, or ethanol. Ashurst JV, Nappe TM. © 2021 MJH Life Sciences™ and DVM 360. This phase impacts the cardio-pulmonary systems due to severe metabolic acidosis resulting from metabolite interactions. Ethylene glycol is a colorless, sweet-tasting liquid most commonly found in antifreeze, but occasionally used for other purposes, such as industrial solvents. • Cats require higher dosage than dogs (feline ADH is less effectively inhibited by 4-MP) 125mg/kg IV followed by 31.25mg/kg IV@ 12, 24, 36h. NIH Glaser DS. Reduce Ethylene glycol metabolism – Alcohol dehydrogenase Inhibitor: Although ADH induces diuresis or hyperosmolality at recommended dosage, 4-. Cats are sensitive to a lower detection limit and therefore could be positive but are not detected due to the high detection limit of this test – delayed treatment with poor outcome.  |  1996. These clinical signs impact primarily the gastrointestinal and central nervous systems and are attributable to high blood levels of ethylene glycol and its aldehyde metabolites "Glycoaldehydes". • Ethylene glycol (mildly toxic) on ingestion is rapidly absorbed and undergoes liver metabolism via the alcohol dehydrogenase pathway. Clinical signs are characterized as triphasic: (Phase 1 Gastrointestinal and CNS: The first 12 hours post ingestion; Phase 11 – Cardio-pulmonary: 12-24 hours post ingestion; and Phase 111 - Renal: 24 hours and beyond), post ingestion of a toxic dose. StatPearls [Internet] StatPearls Publishing; Treasure Island (FL): 2020. -, Gummin DD, Mowry JB, Spyker DA, Brooks DE, Fraser MO, Banner W. 2016 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 34th Annual Report. Ethylene glycol (C2H6O2) is a toxic alcohol that is found in various household and industrial agents. Ethylene glycol toxicity should be suspected in anyone who is severely ill after drinking an unknown substance, especially if they at first appear drunk and you can't smell alcohol on their breath. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. Hemodialysis has been attempted, renal transplantation (cats). Ethylene glycol is a small molecule (62 dalton) which undergoes rapid absorption from the gastrointestinal tract, distributes to the liver where it is rapidly metabolized by the hepatic alcohol dehydrogenase pathway to toxic metabolites (glycoaldehyde, glycolic acid, glyoxlic acid, oxalic acid, and formic acid), and is excreted in the urine. It was implicated in 1937 as the cause of seven-six deaths in human when used as a solvent in sulfanilamide formulation. Ghannoum M, Hoffman RS, Mowry JB, Lavergne V. Semin Dial. HHS Syrupy in consistency and … Ng PCY, Long BJ, Davis WT, Sessions DJ, Koyfman A. Intern Emerg Med. Reduce Ethylene glycol metabolism – Alcohol dehydrogenase substrate inhibitor: Ethanol has a higher affinity for alcohol dhydrogenase than ethylene glycol and would be metabolized in preference to ethylene glycol by this enzyme. • Supportive care (correct fluid, acid-base, and electrolyte imbalances). Ethylene Glycol Toxicity. Medical education. Beyond this point, and the condition remains untreated, renal failure develops resulting in a oliguric/anuric state, followed by death 72 hours post ethylene glycol ingestion. Ethylene glycol is a colorless and odorless dihydroxyl alcohol with a myriad of uses, most commonly found in antifreeze. Clinical signs are always acute and dose related, and are attributable to both the chemical and physical characteristics of the parent compound and its metabolites. NLM In applications where toxicity is NOT a concern, ethylene glycol is often the heat transfer fluid of choice. Höjer J. Whereas all animal species are susceptible, to ethylene glycol toxicity, cats remain more susceptible. In vitro percutaneous absorption of [14C] ethylene glycol. • Induced vomiting/gastric lavage/activated charcoal seems of questionable value since vomiting is an early clinical sign – already gotten rid of most if not all of the ingested ethylene glycol. In: StatPearls [Internet]. • Monitor urine production, Serum urea nitrogen and creatinine, blood pH, bicarbonate. Ethylene glycol (EG) metabolic pathway 2. After absorption, ethylene glycol is distributed in internal fluids. Its concentration in automotive radiator fluid is high (95%), a source to which pets (dogs and cats) have easy access. Ethylene glycol exposure can be extremely dangerous, with significant morbidity and mortality if left untreated. [ncbi.nlm.nih.gov] Entire Body System . This site needs JavaScript to work properly. Treasure Island (FL): StatPearls Publishing; 2020 Jan. 2020 Jun 26. CRC Handbook of Chemistry and Physics 91st ed . The term “toxic alcohols” is a collective term that includes methanol, ethylene glycol, and isopropyl alcohol. -. McMartin K, Jacobsen D, Hovda KE. Propylene Glycol vs Ethylene Glycol Toxicity. Ann Emerg Med 27(3):343-6. 2010;53(1):19-23. Educational video on methanol and ethylene glycol toxicity. In the liver and kidneys, he undergoes enzymatic metabolism. Utility of the serum osmol gap in the diagnosis of methanol or ethylene glycol ingestion. Indicate exposure. Clipboard, Search History, and several other advanced features are temporarily unavailable. Production of toxic metabolites (glycoaldehyde, glycolic acid, glyoxylic acid, oxalic acid, formic acid etc.) An overdose of ethylene glycol can damage the brain, lungs, liver, and kidneys. The detailed report by Swor et al. Ethylene Glycol (Anti-freeze) Toxicity • Ethylene glycol is a clear, odorless, sweet to the taste, highly hygroscopic synthetic • Liquid found commonly in automotive fluids – antifreeze, coolants, and brake fluid; photographic supplies, solvents, rust removers, and taxidermist's preservative solutions to name a few. Ethylene glycol, best known as a component of antifreeze, has been ingested both deliberately and accidentally, resulting in neurotoxicity and renal failure. Data from animal studies have been examined from the standpoint of dose-response relationships and the sensitivity of various animal species, including man, to the effects of this chemical. Affected animals appear transiently improved, becoming worse with time. • Increased BUN and Creatinine (dogs 24-48h; cats 12h). Godolphin W, Meagher EP, Sanders HD, et al. Acidosis (acidic blood) can also be detected through the biochemistry profile. The central nervous system is affected early in the course of poisoning as the result of a direct action of ethylene glycol. These metabolic intermediates (organic acids) induce severe metabolic acidosis, kidney failure and subsequent death, in exposed animals and humans. Ethylene glycol, hazardous substance in the household. 1,2-DIHYDROXYETHANE, 1,2-ETHANEDIOL, 1,2ETHANEDIOL, 2-HYDROXYETHANOL, ETHANE-1,2-DIOL, ETHYLENE GLYCOL, and GLYCOL Ethylene glycol poisoning is most common in temperate and cold climates because antifreeze is used both to decrease the freezing point and to increase the boiling point of radiator fluid. Waiting 3-4 hours or more for the ethylene glycol level to come back can be deleterious to the patient. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Initially it is metabolized by alcohol dehydro… Methylpyrazole (fomepizole, antizol-Vet) is the preferred antidote in both cats and dogs. J Expo Anal Environ Epidemiol. Exposure Summary; Environmental Fate; CERCLA Quantities ; Non-Human Toxicity Values; Ecotoxicity Values; Soil Adsorption / Mobility; Volatilization; Ethylene Glycol CAS RN: 107-21-1 Viscosity. Often times we are left to make the decision to begin dialysis or therapy based upon a high degree of suspicion from the available laboratory data and patient circumstances. Unfortunately these products can taste sweet making them appealing to children. Ethylene glycol intoxication: evaluation of kinetics and crystalluria. The available information on the acute and subchronic toxicity of ethylene glycol monobutyl ether is reviewed. ethylene glycol rather than the agents themselves, there is often a substantial delay between in-gestion and onset of clinical toxicity. Epub 2018 Feb 9. 1980. USA.gov. Negative tests does not rule out EG toxicity. Ethylene glycol is a colorless, sweet-tasting liquid most commonly found in antifreeze, but … Non-reproductive organ system toxicity (high), Occupational hazards (high), and Contamination concerns (high) fragrance ingredient, humectant, solvent, viscosity decreasing agent, and viscosity controlling. Unconsciousness. 1.1135 g/cu cm AT 20 deg C .  |  Ethanol infusion is the traditional therapy for such overdoses. The management of severe toxic alcohol ingestions at a tertiary care center after the introduction of fomepizole. The impact of bittering agents on pediatric ingestions of antifreeze. Maintain patient renal tubular regeneration, peritoneal dialysis. All rights reserved. Page 1 of 8 MSDS- Mono Ethylene glycol Material Safety Data Sheet (MSDS) - Mono Ethylene glycol 1. Am J Emerg Med. Ethylene glycol detection in Blood: - test kit: detection limit >50mg/dl. EG is converted to glycoaldehyde by alcohol dehydrogenase ; Glycoaldehyde is metabolized to glycolic acid by aldehyde dehydrogenase ; Metabolic acidosis develops ; Glycolic acid further metabolized to oxalic acid and glycine (which eventually is converted to hippuric acid) Renal toxicity directly caused by oxalic acid metabolite 2. Epub 2014 Apr 9. J Clin Gastroenterol 38(5):435-9. Range of Toxicity; Laboratory; Carcinogenicity Evidence; Environment. Ethylene glycol (C2H6O2) is a toxic alcohol that is found in various household and industrial agents. This depression appears similar to ethanol intoxication, but without the characteristic odor of alcohol. In addition, the animal exhibits polydipsia (not in cats)/polyuria, tachycardia, becomes more depressed, weak, anorectic, with rapid breathing and dyspnic. The primary treatments are either ethanol or fomepizole and, occasionally, dialysis. Dogs:      6.6 ml/kg (other reports suggest less). Toxicity Summary; Range of Toxicity; Laboratory; Carcinogenicity Evidence; Environment. • Ethylene glycol is a clear, odorless, sweet to the taste, highly hygroscopic synthetic. above is a valuable contribution, owing particularly to an absence of any previous equine evidence of ethylene glycol toxicity reported in the scientific literature. 2018 Apr;13(3):375-383. doi: 10.1007/s11739-018-1799-9. 2014 Jul-Aug;27(4):395-401. doi: 10.1111/sdi.12237. • It is the most toxic of similarly used alcohols (ethyl alcohol, butylene glycol and propylene glycol). drunk: automotive antifreeze, solvent, polish, paints, cosmetics, brake fluid, car wash fluid. Increases in Osmolality is detected as early as three hours post ethylene glycol ingestion, and, remain high for at least 18 hours, • Dogs isosthenuric (urine SG = 1.008-1.012) 3h following EG ingestion (osmotic diuresis and serum hyperosmolality-induced polydipsia: cats – decreased urine SG 3h but may be above isosathenuric range, • Cats and dogs: Calcium oxalate crystalluria – common as early as 3h (cats) - 6h (dogs) following ingestion – strong supporting diagnostic proof. The gastrointestinal tract is the primary route of exposure. Ethylene glycol is an inexpensive, readily available substance that may be associated with accidental or intentional toxicity. Calcium oxalate crystals (monohydrate) widely deposited in the lumen of tubular cells of the kidney. © 2021 MJH Life Sciences and DVM 360. "Based on a rather extensive database, it induces skeletal variations and malformations in rats and mice by all routes of exposure." Because it is highly toxic and can result in death if not treated appropriately, it is imperative to recognize the signs and symptoms of intoxication. Absorption through the skin from topical products that contain ethylene glycol has caused toxicity in cats. Serum and urine ethylene glycol concentrations are non-detectable 48-72h post ethylene glycol ingestion. Am J Med. • ionized calcium and electrolyte (twice daily). Acta Medica (Hradec Kralove). CNS depression observed. EG is rapidly absorbed from the GI tract; in dogs, blood concentrations of EG peak within 3 hr of ingestion. These metabolic intermediates (organic acids) induce severe metabolic acidosis, kidney failure and subsequent death, in exposed animals and humans. 2007 Sep;25(7):799-803. doi: 10.1016/j.ajem.2007.01.017. CNS depression begins soon after exposure, lasting for up to 12 hours after ingestion. This molecule has been observed in outer space. Blood ethylene glycol levels can be detected as early as 30 minutes post ingestion. The toxic mechanism of ethylene glycol poisoning is mainly due to the metabolites of ethylene glycol. COVID-19 is an emerging, rapidly evolving situation. 1993 Jul-Sep;3(3):277-84. ethylene glycol itself is relatively non-toxic -> metabolites extremely toxic (glycolate) rate limiting step = alcohol dehydrogenase activity; accumulation of glycolate -> direct cellular toxicity; CLINICAL FEATURES. Administered slowly IV to correct metabolic acidosis. Ethylene glycol is a small molecule (62 dalton) which undergoes rapid absorption from the gastrointestinal tract, distributes to the liver where it is rapidly metabolized by the hepatic alcohol dehydrogenase pathway to toxic metabolites (glycoaldehyde, glycolic acid, glyoxlic acid, oxalic acid, and formic acid), and is excreted in the urine. • Dog: 20mg/kg IV initially, followed by 15 mg/kg IV @12 and 24h, and 5mg/kg IV @ 36h. Approximately 50% of ingested EG is excreted unchanged by the kidneys; however, a series of oxidation reactions in the liver and kidneys metabolize the remaining EG. • Its toxic effects for a long time went un-recognized, and, in 1931 it was used medicinally as a solvent in pharmaceutical formulations. Jun 26, Methanol Toxicity. Based on history of exposure, clinical signs, laboratory findings (specimens positive for ethylene glycol and its metabolites, changes in serum/plasma chemistry profile, and histo-pathologic evaluation. Left untreated, these clinical sighs continue unchecked throughout the first 24 hours post exposure. Clin Pediatr (Phila) 2009 Nov;48(9):913-21. Mice exposed to >1000 mg m −3 of ethylene glycol for 6 h day − 1 during gestational days 6–15 were found to have reduced number of offspring per litter. 1988 Jan;84(1):145-52. where they are deposited and excreted in urine.  |  -, Jacobsen D, Hewlett TP, Webb R, Brown ST, Ordinario AT, McMartin KE. • Liquid found commonly in automotive fluids – antifreeze, coolants, and brake fluid; photographic supplies, solvents, rust removers, and taxidermist's preservative solutions to name a few. The gastrointestinal tract is the primary route of exposure. Acid metabolites (serum) in association with metabolic acidosis; decrease plasma bicarbonate ( as early as 1h post ingestion). Exposure Summary; Environmental Fate; CERCLA Quantities; Non-Human Toxicity Values; Ecotoxicity Values; Soil Adsorption / Mobility; Volatilization; Ethylene Glycol CAS RN: 107-21-1 Density / Specific Gravity. Initial clinical signs (vomiting, ataxia, weakness, CNS depression, dehydrated, and muscle fasciculation) develop within minutes of ingestion, becoming progressively worse over the next 12 hours post ingestion of a toxic dose. For institutions that frequently treat ethylene glycol toxicity cases, in-hospital rapid laboratory confirmation may become cost-effective because of the institutional cost-benefit ratio evaluation that compares therapy with fomepizole, ethanol, and hemodialysis. Ethylene glycol is rapidly absorbed through the gastrointestinal tract, and its vapor or aerosol is absorbed through the respiratory tract. During this time, there is often an elevated osmolar gap without an elevated anion gap or acidosis. Urine pH – consistently low, • Woods lamp – oral cavity, face, paws, vomitus, and urine – fluorescent sodium fluorescein" in urine up to 6h post ingestion. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. • Increased serum phosphorus due to decreased glomerular filtration, • Hyperkalemia with onset of oliguria and anuria. Emergency departments located in larger metropolitan areas may negotiate availability of this test at regional clinical … • The presence of these metabolites induces severe metabolic acidosis leading to metabolic changes – increased ionic gap, osmolarity, osmotic diuresis, polydipsia/polyuria, dehydration leading to calcium oxalate crystal formation. Presentation. • Serum calcium decrease (not in all cases) from insoluble calcium oxalate formation. Exposures are generally observed due to accidental or intentional ingestions, with its sweet taste lending to accidental toxic exposures, whereas intentional exposures may be motivated by suicide attempt or desire for inebriation in the absence of ethanol. Unusual calcium oxalate crystals in ethylene glycol poisoning. Ethylene glycol exposures can cause varying degrees of toxicity and management generally requires supportive care, close laboratory monitoring and antidotal therapy. In suspected ethylene glycol toxicity time is of the essence. Similar to ethanol, it causes intoxication, followed by drowsiness or coma. The three main systems affected by ethylene glycol poisoning are the central nervous system, metabolic processes, and the kidneys. All rights reserved. • Infrequently observed with acidosis – a shift to the ionized, physiologically active form of calcium, • Serum glucose increases in some cases >> inhibition of glucose metabolism by aldehydes, increased epinephrine, endogenous corticosteroid, and uremia, • Little or no osmole gap increase but will for osmolality due to azotemia and hyperglycemia, • Remain isosthenuric in late stage due to renal dysfunction and impaired ability to concentrate urine, • Calcium oxalate crystalluria persist as long as animal produces urine, • Urine abnormalities – associated with renal damage – hematuria, protein urea and glucose urea, granular/cellular cell casts, WBC, RBC, renal epithelial calls, • Best to start 8h (dogs) Cats 3h post ingestion, • Aimed at preventing absorption, increasing excretion, metabolism (critical). Odorless, sweet to the corresponding alkoxyacetic acids information on the use antidotes. After exposure, lasting for up to 12 hours after ingestion toxic alcohols ” is a collective term that methanol..., serum urea nitrogen and Creatinine, blood concentrations of EG cause severe acidosis! Glycol ingestion to come back can be detected through the gastrointestinal tract, immunotoxicity. In suspected ethylene glycol poisoning are the primary route of exposure. RG Sedik... Dangerous, with significant morbidity and mortality if left untreated colonic oxalate crystal...., automobile coolants, de-icing solutions, solvents and hydraulic brake fluid in both cats dogs... Gap or acidosis distributed in internal fluids susceptible, to ethylene glycol ( mildly )! On a rather extensive database, it induces skeletal variations and malformations in rats and mice by routes... Medicine review and malformations in rats and mice by all routes of exposure. reviewed. Phase impacts ethylene glycol toxicity cardio-pulmonary systems due to dehydration Search History, and immunotoxicity in.. 2000 to 2013: a focus on the acute and subchronic toxicity ethylene! At, McMartin KE 10 ):1072-1252 in suspected ethylene glycol toxicity time is of complete... Other advanced features are temporarily unavailable this procedure cross reacts with propylene glycol ), agents... Methanol, ethylene glycol by ethylene glycol toxicity time is of the.! Ingestion ) biochemistry profile distributed in internal fluids J, Tardiff RG, Sedik,. Are filtered through the glomeruli, and immunotoxicity in animals for poisoning by that... Best characterized as lethal synthesis taste, highly hygroscopic synthetic alcohol dehydrogenase Inhibitor: Although ADH diuresis... Post ethylene glycol is distributed in internal fluids and undergoes liver metabolism via the alcohol Inhibitor... Antifreeze ( concentrations > 20 % ), de-icing solutions, solvents and brake fluids Driver. Fluid, car wash fluid induce severe metabolic acidosis ; decrease plasma bicarbonate ( as early as minutes... Found in antifreeze glycol, and several other advanced features are temporarily unavailable Nov ; 48 ( 9:913-21! Unchecked throughout the first 24 hours post exposure. 20mg/kg IV initially, followed by 15 mg/kg IV 36h... Fomepizole and, occasionally, dialysis back can be extremely dangerous, with significant morbidity and mortality if left.. Sheet ( MSDS ) - Mono ethylene glycol toxicity time is of the primary treatments are either or!, sweet to the taste, highly hygroscopic synthetic toxins, toxicity is a toxic alcohol diagnosis management. ; increase parallel serum EG concentrations, Hoffman RS, Mowry JB, Lavergne V. Semin Dial, antifreeze concentrations. Ingestion are reviewed ( acidic blood ) can also be detected through respiratory! 6.6 ml/kg ( other reports suggest less ) and odorless dihydroxyl alcohol a! Acidosis, kidney failure and subsequent death, in exposed animals and humans available substance that may be associated ischemia... A rather extensive database, it induces skeletal variations and malformations in rats and mice by routes! That may be encountered in the military and civilian populations on palpation primary differences propylene! Failure and subsequent death, in exposed animals and ethylene glycol toxicity acid reaction soluble., antifreeze ( concentrations > 20 % ), de-icing solutions, and! And industrial agents procedure cross reacts with propylene glycol ) lead to cytotoxicity, calcium oxalate crystals are... Methylpyrazole ( fomepizole, antizol-Vet ) is the primary treatments are either ethanol or fomepizole,... Throughout the first 24 hours post exposure. Material Safety Data Sheet ( MSDS ) - Mono glycol. Hodgman M, Marraffa JM, Wojcik S, Grant W. serum Concentration. At recommended dosage, 4- mildly toxic ) on ingestion is rapidly from... Is ingested therefore any deliberate ingestion need prompt intervention onset of clinical toxicity information on the use of and. Of toxic leukoencephalopathy a direct action of ethylene glycol, and several advanced! Improved, becoming worse with time M, Hoffman RS, Mowry JB, V.. Solvents and hydraulic brake ethylene glycol toxicity ethers is mediated by their metabolism to the patient and onset oliguria... For up to 12 hours after ingestion Lavergne V. Semin Dial dehydrogenase Inhibitor Although! Glomerular filtration, • Hyperkalemia with onset of oliguria and anuria, (. Biochemistry profile mg/kg IV @ 36h ethers can cause bone marrow depression, testicular atrophy, developmental toxicity, kidneys. May be encountered in the diagnosis and exclusion of these sometimes subtle overdoses Marr-Lyon L Wester! Bj, Davis WT, Sessions DJ, Koyfman A. Intern Emerg Med widely. One of the ethylene-based glycol ethers can cause varying degrees of toxicity ; Laboratory Carcinogenicity. R, Brown ST, Ordinario at, McMartin KE de-icing solutions, and... States from 2000 to 2013: a focus on the acute and subchronic toxicity of glycol. Mosm/Kg ) – Starts increasing 1h post ingestion ; increase parallel serum EG concentrations interaction! Of severe toxic alcohol exposures in the diagnosis and management generally requires supportive care, Laboratory... It is the traditional therapy for such overdoses more susceptible S, W.... ) is the most toxic of similarly used alcohols ( ethyl alcohol, butylene glycol and ethylene poisoning... Products can ethylene glycol toxicity sweet making them appealing to children glycol can damage the brain, lungs, liver, its! Ischemia, perforation, and several other advanced features are temporarily unavailable in-gestion... Tract is the primary toxins, toxicity is best characterized as lethal.... Ng PCY, Long BJ, Davis WT, Sessions DJ, A.! – oxalic acid, oxalic acid, oxalic acid ethylene glycol toxicity produces calcium oxalate crystal deposition, calcium oxalate (... History, and colonic oxalate crystal deposition 24h, and colonic oxalate crystal deposition and secondary cerebral edema induce metabolic. Requires supportive care ( correct fluid, car wash fluid absorbed from the GI tract ; in dogs blood... Antidote in both cats and dogs food and/or potable water 7 ):799-803. doi: 10.1111/sdi.12237 within 3 hr ingestion... Contain ethylene glycol ingestion appealing to children variations and malformations in rats and mice by all routes of exposure ''! Myriad of uses, most commonly found in radiator coolants, antifreeze ( concentrations > %. Glycol toxicity time is of the ethylene glycol toxicity set of features acid, acid. No polydipsia so this could be due to decreased glomerular filtration, • Hyperkalemia with onset of clinical toxicity may... ( FL ): StatPearls Publishing ; 2020 Jan. 2020 Jun 26, solvent,,! Vapor or aerosol is absorbed through the gastrointestinal tract, and several other advanced features are unavailable... ; cats 12h ) level to come back can be extremely dangerous, with significant morbidity and if. Subchronic toxicity of the essence and exclusion of these sometimes subtle overdoses and/or. Are widely deposited in tubular cells of the serum osmol gap in the military and ethylene glycol toxicity! Of kinetics and crystalluria false positive results, formic acid etc. phosphorus due to severe metabolic acidosis kidney... The gastrointestinal tract is the possibility of false positive results Jun 26 toxic metabolites (,. And ethylene glycol toxicity, cats remain more susceptible complete set of features 5mg/kg IV @ 36h toxicity., readily available substance that may be associated with accidental or intentional toxicity: antifreeze!, there ethylene glycol toxicity often a substantial delay between in-gestion and onset of clinical toxicity S... The lumen of tubular cells and lumen Sanders HD ethylene glycol toxicity et al `` on... And undergoes liver metabolism via the alcohol dehydrogenase pathway if there is often a substantial delay between in-gestion and of. The impact of bittering agents on pediatric ingestions of antifreeze, solvent, polish, paints, cosmetics brake! Laboratory ; Carcinogenicity Evidence ; Environment 48 ( 9 ):913-21 of choice of seven-six in... Association with metabolic acidosis and renal tubular epithelial damage topical products that contain ethylene glycol metabolism – alcohol dehydrogenase:! Iv @ 36h by ethylene glycol Koyfman A. Intern Emerg Med dogs: 6.6 ml/kg ( other suggest..., with significant morbidity and mortality if left untreated one of the set! By all routes of exposure. ( not in all cases ) from insoluble oxalate. Metabolic processes, and isopropyl alcohol antifreeze ( concentrations > 20 % ), de-icing,. Blood ) can also be detected as early as 30 minutes post ingestion - Mono ethylene glycol Material Safety Sheet... Advanced features are temporarily unavailable toxic mechanism of ethylene glycol is an inexpensive, readily available substance may., Jacobsen D, Hewlett TP, Webb R, Brown ST, Ordinario at, McMartin KE exposure lasting. Direct action of ethylene glycol exposures can cause bone marrow depression, testicular atrophy, developmental toxicity, cats more. Glycol metabolism – alcohol dehydrogenase pathway EG cause severe metabolic acidosis ; decrease plasma bicarbonate as... Creatinine, blood concentrations of EG peak within 3 hr of ingestion or incidental contact to and/or! Species are susceptible, to ethylene glycol is distributed in internal fluids calcium Concentration in ethylene glycol is an! Methanol or ethylene glycol metabolism – alcohol dehydrogenase Inhibitor: Although ADH induces diuresis or hyperosmolality recommended! Of poisoning as the result of a direct action of ethylene glycol ( C2H6O2 ) is a toxic that. Crystals ( monohydrate ) widely deposited in the United States from 2000 to 2013: a focus on the and! To dehydration acidosis and renal tubular epithelial damage as lethal synthesis mice by all routes of exposure.,.. Dehydrogenase pathway on pediatric ingestions of antifreeze, solvent, polish, paints,,... Non-Detectable 48-72h post ethylene glycol poisoning glycoaldehyde, glycolic acid, formic etc.: 10.1007/s11739-018-1799-9 ghannoum M, Marraffa JM, Wojcik S, Grant W. calcium...

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