whewellite and Coma

When seen, some habits of calcium oxalate monohydrate crystals (whewellite) are so typical of ethylene glycol intoxication that they may be helpful for its diagnosis when circumstances are not clearly established.

Topics: Acidosis; Adult; Alcoholism; Anuria; Calcium Oxalate; Coma; Crystallization; Ethylene Glycol; Female; Hemofiltration; Humans; Male; Middle Aged; Poisoning; Renal Dialysis; Suicide, Attempted

During the course of a case of ethylene glycol poisoning with ensuing oliguric renal failure despite early dialysis, we show the importance of early diagnosis of this intoxication in underlined. Characteristics of ethylene glycol poisoning are: metabolic acidosis with anion gap (without lactic acidosis or keto-acidosis) and high plasma osmolarity. Awaiting the result of blood and urinary toxic values, crystalluria, by typical needle monohydrate calcium oxalate crystals finding, evokes the diagnosis and permits to start a specific treatment. This treatment is based on: principles of intensive care, ethanol administration (or 4-methyl-pyrazole now available), also thiamine and pyridoxine administration and finally, dialysis therapy. We can hope, with early and intensive management of this poisoning, to prevent the renal failure, principal complication of ethylene glycol ingestion, which can lead to chronic renal failure. Therefore, crystalluria, an easy and specific diagnosis technic, is of great interest.

Topics: Acidosis; Acute Kidney Injury; Alcoholism; Calcium Oxalate; Coma; Creatinine; Ethanol; Ethylene Glycol; Ethylene Glycols; Humans; Male; Middle Aged; Oliguria; Poisoning; Renal Dialysis