Author/Editor		Lainščak, Mitja; Petric, Vlasta; Mikolič, Rudolf; Štivan, Franc
Title		Zastrupitev z etilenglikolom ob hkratnem zaužitju etanola
Translated title		Ethylene glycol poisoning with concurrent ethanol ingestion
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. 2
Publication year		2003
Volume		str. 59-62
Language		slo
Abstract		Background. Ethylene glycol, usually ingested by coincidence, causes uncommon but serious poisoning which could have fatal consequences without prompt diagnosis and treatment. Ethylene glycol itself has a low toxicity but is rapidly degraded to toxic metabolites, that are responsible for typical clinical presentation. Metabolic acidosis, increased anion and osmolalgap are typical laboratory findings. Application of antidotes ethanol and fomepizol, hemodyalisis and correction of metabolic acidosis are mainstays of therapy. Patients and methods. A case of concurrent ethanol and ethylene glycol ingestion is presented. On admission diagnosis of ethylene glycol poisoning was supported by heteroanamnestic data, typical clinical presentation and laboratory findings and latter confirmed with body fluid analysis. Despite therapy with ethanol, sodium hydrogencarbonate and parenteral hydration patient developed acute renal failure which required hemodyalisis. Conclusions. Concurrent ingestion of spirit improved prognosis of ingestion of lethal ethylene glycol dose. Due to late arrival adequate and immediate in-hospital management could not prevent acute renal failure and subsequent hemodyalisis.
Summary		Izhodišča. Zastrupitve z etilenglikolom so redke, večinoma nenamerne in brez zdravljenja velikokrat smrtne. Klinična slika je posledica delovanja strupenih razgradnih produktov razmeroma malo strupenega etilenglikola. Metabolna acidoza in povišani anionska ter osmolalna vrzel so najpomembnejši laboratorijski znaki, zdravljenje pa temelji na čimprejšnjem dajanju antidota etanola alifomepizola, hemodializi in ureditvi kislinsko-baznega ravnotežja. Bolniki in metode. Prikazan je primer bolnice, ki je sočasno zaužila etilenglikol in žgano pijačo. Ob sprejemu so bili ugotov jeni heteroanamnestični podatki ter značilni klinični in laboratorijski znaki zastrupitve z etilenglikolom: Diagnozo smo potrdili z dokazom etilenglikola v telesnih tekočinah. Bolnico smo zdravili z etanolom, natrijevim hidrogenkarbonatom in jo parenteralno hidrirali, vendar je kljub temu prišlo do akutne ledvične odpovedi, zaradi katere smo opravili hemodializo. Zaključki. Sočasno zaužitje žgane pijače je ob zaužitju smrtnega odmerka etilenglikola izboljšalo izid zastrupitve. Kljub ustreznemu in takojšnjemu zdravljenju v bolnišnici je pri bolnici zaradi prepoznega prihoda prišlo do akutne ledvične odpovedi, ki smo jo zdravili s hemodializo.
Descriptors		ETHYLENE GLYCOLS ALCOHOL DRINKING ALCOHOL, ETHYL KIDNEY FAILURE, ACUTE AGED