Studies on ethylene glycol poisoning: One patient – 154 admissions

Objective. Fomepizole is the antidote of choice in toxic alcohol poisonings. Potential side effects from frequent use of fomepizole were studied in a patient admitted 154 times with ethylene glycol (EG) poisoning. The intra-individual correlation between the serum-ethylene glycol (serum-EG) and the osmolal gap (OG) EG-kinetics, and other laboratory parameters were also studied. Methods. Combined pro- and retrospective collection of material from three different hospitals, and results from autopsy. Results. A 26-year-old female with a dissociative disorder was admitted with EG poisoning a total of 154 times. Her admission data revealed a median pH of 7.31 (range 6.87–7.49), pCO2: 4.2 kPa (1.2–6.7) (32 mmHg [9–50]), HCO–3: 15 mmol/L (4–26) (15 mEq/L [4–26]), base deficit (BD): 10 mmol/L (− 4 to 27) (10 mEq/L [–4 to 27]), serum-creatinine 65 μmol/L (40–133) (0.74 mg/dL [0.45–1.51]), OG 81 mOsm/kgH2O (25–132), and serum-EG 44 mmol/L (4–112) (250 mg/dL [25–700]). She was treated with fomepizole 99 times, ethanol 60 times (with a combination of both six times), and dialysis 73 times. The correlation between serum-EG and OG was good (r2 = 0.76). She was finally found dead outside hospital with an EG blood concentration of 81 mmol/L (506 mg/dL). An autopsy revealed calcium oxalate crystals...