Abstract
A 46-year-old woman intentionally ingested ethylene glycol and overdosed on paracetamol. She had clinical and laboratory features suggestive of ethylene glycol poisoning, and examination of the urine revealed calcium oxalate monohydrate, or ‘picket fence’, crystals. She responded well to therapy that included haemodialysis. Clinicians should be aware that these crystals appear late during the evolution of ethylene glycol poisoning and, along with other clinical and laboratory findings, should prompt the initiation of haemodialysis.
Highlights
A 46-year-old woman intentionally ingested ethylene glycol and overdosed on paracetamol
A 46-year-old woman with a history of depression presented to the emergency department (ED) 12 hours following an overdose of 25 g of paracetamol tablets and 500 mL of anti-freeze
The patient was started on 70% ethanol in 5% dextrose water via nasogastric tube over a 10-hour period, as well as N-acetylcysteine by intravenous infusion
Summary
A 46-year-old woman intentionally ingested ethylene glycol and overdosed on paracetamol. A 46-year-old woman with a history of depression presented to the emergency department (ED) 12 hours following an overdose of 25 g of paracetamol tablets and 500 mL of anti-freeze. Her random blood glucose was 13.2 mmol/L and a urine dipstick was negative for ketones. Arterial blood gas revealed metabolic acidosis with a pH of 7.13, bicarbonate of 10.4 mmol/L and a lactate concentration of 10.6 mmol/L.
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