T52.3

Clinical Causes: Accidental ingestion of antifreeze or de-icing products containing ethylene glycol or methylene glycol. Inappropriate handling or storage of glycol-containing substances, leading to accidental exposure. Intentional ingestion in cases of poisoning or suicide attempts. Inhalation of vapors or aerosols from products containing glycols in occupational settings. Dermal contact with glycol-containing products, especially if prolonged or with damaged skin.

Key Symptoms: Initial signs may include nausea, vomiting, and abdominal pain. Delayed symptoms such as dizziness, drowsiness, and weakness. Signs of more severe toxicity may involve difficulty breathing, confusion, seizures, and coma. In cases of ethylene glycol poisoning, there may be metabolic acidosis and kidney failure. Other symptoms can include dehydration, tachypnea (rapid breathing), and characteristic calcium oxalate crystal formation in the urine.

Diagnosis Path: Diagnosis of glycol toxicity involves a combination of medical history, clinical examination, and laboratory tests. Blood tests may reveal metabolic acidosis, elevated serum osmolarity, and the presence of calcium oxalate crystals. Specific assays to measure serum glycol levels can confirm exposure. Imaging studies are not typically definitive but may be used to assess organ damage in severe cases. Early recognition and detection are critical, as symptoms can be nonspecific initially.

Treatment Protocols: Immediate decontamination, such as gastric lavage or administration of activated charcoal if ingestion is recent. Supportive care to maintain airway, breathing, and circulation. Use of specific antidotes like fomepizole or ethanol, which inhibit alcohol dehydrogenase to prevent the formation of toxic metabolites. Correction of metabolic acidosis with bicarbonate therapy. Hemodialysis may be necessary in severe cases to remove toxins and correct acid-base disturbances. Monitoring and supporting organ function, particularly kidney health.