Marzo Aprile 2023 - Nefrologo in corsia

A case of acute kidney injury due to ethylene glycol intoxication

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Giulia Lieti

Giulia Lieti 1, Vincenzo L’imperio 2, Andrea Cavalli3, Chiara Ravasi3, Selena Longhi3, Giovanni Battista Fogazzi4, Vincenzo La Milia3

1 Università degli studi di Milano-Bicocca, Scuola di Specializzazione in Nefrologia
2 S.C. Anatomia Patologica I, Ospedale San Gerardo, Monza
3 U.O. Nefrologia e dialisi, Ospedale A. Manzoni, Lecco
4 Laboratorio clinico e di ricerca sul sedimento urinario, SC di Nefrologia, Dialisi e Trapianto di Rene, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano

Corresponding author:
Giulia Lieti
Università degli studi di Milano-Bicocca, Scuola di Specializzazione in Nefrologia
20900, Monza, Italia
E-mail: g.lieti@campus.unimib.it

 

Abstract

In this article we describe a case of acute kidney injury caused by ethylene glycol intoxication which partially reversed after temporary hemodialysis treatment. The diagnosis was obtained after the patient’s clinical history and the finding of ethylene glycol in the blood, numerous intratubular crystals at renal biopsy, and the presence of large amounts of atypical – spindle-like and needle-like – calcium oxalate crystals in the urinary sediment.

Keywords: Ethylene glycol, acute kidney injury, urinary sediment, calcium oxalate crystals

Introduction

Ethylene glycol (EG) is a fluid used in antifreeze solutions, whose ingestion occurs by mistake (especially in children and in work accidents) or intentionally, for suicidal purposes or for its ethanol-like euphoric effect [1]. The ingestion of EG causes a multiorgan involvement including the kidneys due to acute intratubular calcium oxalate precipitation with consequent tubular obstruction and acute kidney injury (AKI) [2, 3].

In this article, we describe a patient who developed AKI after EG ingestion for suicidal purposes, which partially reversed after hemodialysis treatment. 

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