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14 June 2018 : Case report  Denmark

Rapid Diagnosis of Ethylene Glycol Poisoning by Urine Microscopy

Challenging differential diagnosis

Hussam Mahmoud Sheta1ABEF, Issam Al-Najami2EF, Heidi Dahl Christensen3EF*, Jonna Skov Madsen45ABEF

DOI: 10.12659/AJCR.908569

Am J Case Rep 2018; 19:689-693

Abstract

BACKGROUND: Ethylene glycol poisoning remains an important presentation to Emergency Departments. Quick diagnosis and treatment are essential to prevent renal failure and life-threating complications.

CASE REPORT: In this case report, we present a patient who was admitted unconscious to the hospital. Ethylene glycol poisoning was immediately suspected, because the patient had previously been hospitalized with similar symptoms after intake of antifreeze coolant. A urine sample was sent for microscopy and showed multiple calcium oxalate monohydrate (COM) crystals, which supported the clinical suspicion of ethylene glycol poisoning. The patient was treated with continuous intravenous ethyl alcohol infusion and hemodialysis. Two days after admission, the patient was awake and in clinical recovery.

CONCLUSIONS: Demonstration of COM crystals using microscopy of a urine sample adds valuable information supporting the clinical suspicion of ethylene glycol poisoning, and may serve as an easy, quick, and cheap method that can be performed in any emergency setting.

Keywords: Calcium Oxalate, Ethylene Glycol, Poisoning

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923