[Accidental glycol poisoning].
An acute ethylene glycol intoxication is reported. 100 to 130 ml monoethylene glycol which is used as antifreeze were taken by mistake. On admission to hospital the 41-year-old patient was not remarkable. Despite the lethal dose--according to literature--no renal failure developed by immediate intravenous ethanol therapy. While the patient was given 10 g of ethanol hourly, the serum glycol level decreased steadily (93 mg/dl). After a short oral treatment with 5 to 7 g of ethanol hourly, the serum glycol increased to 350 mg/dl, but could be lowered again--after the reinstitution of the intravenous therapy--to those values recorded before the oral therapy. The level of blood ethanol differed between 2.41 and 0.01 mg/l. The creatinine clearance was normal and the serum electrolytes could be kept in the normal range with adequate compensation despite of the polyuria of 13.81/24 h. It is known that even a low ethanol level inhibits the enzymic metabolism of ethylene glycol by ethanol dehydrogenase and prevents the formation of toxic metabolites. The patient luckily had already consumed about 40 g of alcohol (2 bottles of beer), so that an ethanol level existed already before this intoxication. From this case report one could conclude, that the parenterally given ethanol influences the serum glycol level far better than the orally given especially in case it is not more than 7 g/h. If glycol intoxication is sure, hemodialysis is--despite this especially good course of conservative treatment--the more efficient and quicker method because of its good ability of elimination.