Question 1

What is Ethylene Glycol Poisoning?

Accepted Answer

Ethylene glycol poisoning is a life-threatening medical emergency that occurs when someone ingests antifreeze or other products containing ethylene glycol. It is caused by the toxic breakdown of ethylene glycol into glycolic acid and oxalic acid, which severely damage the kidneys, nervous system, heart, and lungs. The Ethylene Glycol Urine Test is the most important test for diagnosis because it directly measures ethylene glycol levels in the urine to confirm poisoning and guide emergency treatment.

Question 2

What causes ethylene glycol poisoning?

Accepted Answer

Ethylene glycol poisoning is caused by ingesting or being exposed to ethylene glycol, the sweet-tasting, colorless liquid found in antifreeze, coolants, de-icing solutions, and some industrial products. Once inside the body, ethylene glycol is metabolized by alcohol dehydrogenase into toxic byproducts including glycolic acid and oxalic acid, which attack vital organs. The sweet taste makes it particularly dangerous as accidental ingestion can occur, especially in children and pets, and intentional consumption has occurred in cases of suicide attempts or when mistaken for alcohol.

Question 3

What is the best test for ethylene glycol poisoning?

Accepted Answer

The Ethylene Glycol Urine Test is the most important test for ethylene glycol poisoning because it directly measures the concentration of ethylene glycol in urine, providing definitive evidence of exposure and poisoning. This test detects elevated levels of the toxin itself before it has been fully metabolized into more dangerous compounds, allowing healthcare providers to begin life-saving treatment immediately. Blood tests may also be used to measure serum ethylene glycol levels, osmolal gap, anion gap, and kidney function markers, but the urine test remains essential for confirming diagnosis and monitoring treatment effectiveness in suspected poisoning cases.

Question 4

When should I get tested for ethylene glycol poisoning?

Accepted Answer

You should get tested immediately if you or someone else has ingested antifreeze or any product containing ethylene glycol, or if poisoning is suspected based on symptoms. Seek emergency medical attention right away if you notice symptoms appearing within 30 minutes to 12 hours after potential exposure, including nausea, vomiting, confusion, slurred speech, drowsiness, seizures, or symptoms resembling alcohol intoxication without alcohol consumption. Early testing and treatment within the first few hours are critical to prevent irreversible kidney failure, brain damage, and death, as the toxic effects progress rapidly once ethylene glycol begins metabolizing in the body.

Question 5

What are the symptoms of ethylene glycol poisoning?

Accepted Answer

Symptoms of ethylene glycol poisoning occur in three stages and progress rapidly after ingestion. The first stage (30 minutes to 12 hours) mimics alcohol intoxication with nausea, vomiting, slurred speech, confusion, drowsiness, and lack of coordination. The second stage (12 to 24 hours) involves rapid heart rate, high blood pressure, and metabolic acidosis as toxic metabolites accumulate. The third stage (24 to 72 hours) brings severe kidney damage with flank pain, decreased urine output or no urine, along with potential lung, heart, and neurological complications including seizures, coma, and respiratory failure if untreated.

Question 6

Who is at risk for ethylene glycol poisoning?

Accepted Answer

Anyone with access to antifreeze or ethylene glycol-containing products is at risk, but certain groups face higher danger. Young children are at increased risk due to accidental ingestion, as the sweet taste is appealing and they may drink it unknowingly. People with access to automotive products, industrial workers, and those in cold climates who store antifreeze are also at risk. Individuals experiencing suicidal ideation or those who intentionally consume it as a cheap alcohol substitute represent another high-risk group. Pets, particularly dogs and cats, are also highly susceptible to poisoning from antifreeze spills or open containers.

Question 7

What happens if ethylene glycol poisoning is left untreated?

Accepted Answer

Untreated ethylene glycol poisoning leads to severe, life-threatening complications and death in most cases. The toxic metabolites glycolic acid and oxalic acid cause progressive damage starting with severe metabolic acidosis, which disrupts the body's pH balance and cellular function. Within 24 to 72 hours, acute kidney failure develops as calcium oxalate crystals form and deposit in the kidneys, potentially causing permanent renal damage requiring lifelong dialysis. Neurological damage including seizures, brain swelling, and coma can occur, along with cardiac arrhythmias, respiratory failure, and multi-organ failure. Without emergency treatment with antidotes like fomepizole or ethanol, ethylene glycol poisoning has a high mortality rate.

Question 8

Can ethylene glycol poisoning be diagnosed with a blood test?

Accepted Answer

Yes, ethylene glycol poisoning can be diagnosed with both blood and urine tests that detect the toxin and its metabolic effects. The Ethylene Glycol Urine Test directly measures ethylene glycol levels in urine and is a primary diagnostic tool. Blood tests can measure serum ethylene glycol concentration, osmolal gap (the difference between calculated and measured osmolality), anion gap (indicating metabolic acidosis), and kidney function markers like creatinine and blood urea nitrogen. Additional tests may include blood gas analysis to assess acidosis, calcium levels (often low due to oxalate binding), and urinalysis to detect calcium oxalate crystals, which are characteristic of ethylene glycol metabolism.

Question 9

How is ethylene glycol poisoning treated?

Accepted Answer

Ethylene glycol poisoning is treated as a medical emergency requiring immediate hospitalization and aggressive intervention. The primary treatment is administering fomepizole (Antizol) or ethanol, which block alcohol dehydrogenase to prevent ethylene glycol from being metabolized into toxic compounds. Supportive care includes intravenous fluids, sodium bicarbonate to correct metabolic acidosis, thiamine and pyridoxine to enhance toxin elimination, and calcium supplementation if levels are low. In severe cases with significant kidney damage or high toxin levels, hemodialysis is performed to rapidly remove ethylene glycol and its toxic metabolites from the bloodstream while also correcting acid-base imbalances. Treatment must begin within hours of ingestion for the best outcomes.

Question 10

How can I prevent ethylene glycol poisoning?

Accepted Answer

Prevention of ethylene glycol poisoning focuses on safe storage and handling of antifreeze and related products. Store all antifreeze containers in locked cabinets or areas inaccessible to children and pets, and always keep products in their original labeled containers, never in drinking bottles or unlabeled containers. Clean up any antifreeze spills immediately and thoroughly, dispose of old antifreeze properly at hazardous waste facilities, and consider switching to propylene glycol-based antifreeze products, which are less toxic alternatives. Educate family members about the dangers of antifreeze, supervise children around areas where automotive work occurs, and seek immediate medical attention if any ingestion or exposure is suspected.

Question 11

What can I do at home for ethylene glycol poisoning?

Accepted Answer

Do not attempt home treatment for ethylene glycol poisoning, as this is a life-threatening medical emergency requiring immediate professional intervention. If poisoning is suspected, call 911 or the Poison Control Center at 1-800-222-1222 immediately and get the person to an emergency room without delay. Do not induce vomiting unless specifically instructed by poison control, and do not give the person anything to eat or drink unless directed by medical professionals. If the person is unconscious, having seizures, or not breathing, call 911 immediately and begin CPR if trained. Time is critical in ethylene glycol poisoning, and every minute counts in preventing permanent organ damage or death, so emergency medical treatment is absolutely essential.

Question 12

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Accepted Answer

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Question 13

How do I know which test to get?

Accepted Answer

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Question 14

When will my lab results be available?

Accepted Answer

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Question 15

Is it possible to make changes to my lab order if I made a mistake with the name, date of birth, or any other details?

Accepted Answer

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Question 16

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Accepted Answer

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Question 17

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Accepted Answer

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Question 18

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Accepted Answer

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Ethylene Glycol Poisoning Blood Test

What is Ethylene Glycol Poisoning?

What causes ethylene glycol poisoning?

What is the best test for ethylene glycol poisoning?

When should I get tested for ethylene glycol poisoning?

References

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