Ethylene Glycol Toxicity and Its Therapy Management: A Literature Review

https://doi.org/10.22146/jmpf.81552

Robi Kurniawan(1*), Suci Hanifah(2)

(1) *) Student of Master Degree Program, Universitas Islam Indonesia, Yogyakarta *) Puskesmas Tanjung Batu, Ogan Ilir, Sumatera Selatan
(2) Department of Pharmacy, Universitas Islam Indonesia, Yogyakarta
(*) Corresponding Author

Abstract


Background: Ethylene glycol (EG) is an antifreeze substance commonly used as an additive for syrup preparations. One of the detrimental effects caused by EG toxicity is acute renal failure (ARF) and death, assuming therapy and management are delayed. Presently, there are limited studies on toxicity of EG and therapy. Therefore, this study aimed to provide an overview of EG toxicity levels, clinical manifestations, arising reactions, and therapy management methods.

Objectives: A narrative review design was employed with data collected from PubMed and Google Scholar. The strategy used keywords such as “ethylene glycol toxicity” and "acute renal" with the assistance of Boolean operators including AND and OR.

Methods: The result showed that the minimum EG level for toxicity was at 22 mg/dL, followed by metabolic acidosis with an increased anion gap (>10mmol/L). Based on case reports from one experimental study, the clinical manifestations of patients experiencing EG poisoning included decreased consciousness, tachycardia, and coma, with ARF occurring after 24-72 hours.

Results: Write study findings in this section.

Conclusion: EG poisoning could cause kidney damage in the form of ARF and lead to death, assuming therapy was delayed. Presently, the most effective therapy for EG poisoning was fomepizole.

Keywords


ethylene glycol; renal failure; therapy; toxicity

Full Text:

PDF


References

  1. Mumpuni RY. Tata Laksana Keracunan Minuman Keras Opolosan (Metanol dan ethylene Glycol) Dengan Fomefizole, Etanol, dan Hemodialisis. Journal Nursing Care and Biomolecular. 2017;1(1):1. doi:10.32700/jnc.v1i1.3
  2. Silva RFD, Sumanadasa HS, Wijekoon S, Kamani J, Wanigasuriya P. Two Cases of Ethylene Glycol Poisoning Treated Successfully with Haemodialysis.
  3. Medical Product Alert N°6_2022_ Substandard (contaminated) paediatric medicines.html.
  4. Stašinskis R, Stašinska K, Mukāns M, Graudiņš A, Liguts V, Lejnieks A. Changes in ionized calcium in ethylene glycol poisoning. Baylor University Medical Center Proceedings. 2022;35(4):460-465. doi:10.1080/08998280.2022.2062550
  5. Bhalla A. Bedside point of care toxicology screens in the ED: Utility and pitfalls. Int J Crit Illn Inj Sci. 2014;4(3):257. doi:10.4103/2229-5151.141476
  6. Ahmad Y, Kissling S, Torrent C. The three biological gaps and hyperoxaluria in ethylene glycol poisoning: case presentation and review. Published online 2021.
  7. McQuade DJ, Dargan PI, Wood DM. Challenges in the diagnosis of ethylene glycol poisoning. Ann Clin Biochem. 2014;51(2):167-178. doi:10.1177/0004563213506697
  8. Scalley RD, Ferguson DR, Smart ML, Archie TE. Treatment of Ethylene Glycol Poisoning. 2002;66(5):6.
  9. Cox RD, Phillips WJ. Ethylene Glycol Toxicity. Military Medicine. 2004;169(8):660-663. doi:10.7205/MILMED.169.8.660
  10. Leth PM, Gregersen M. Ethylene glycol poisoning. Forensic Science International. 2005;155(2-3):179-184. doi:10.1016/j.forsciint.2004.11.012
  11. Gallagher N, Edwards FJ. The Diagnosis and Management of Toxic Alcohol Poisoning in the Emergency Department: A Review Article. Advanced Journal of Emergency Medicine. 2019;3(3):e28. doi:10.22114/ajem.v0i0.153
  12. Hodgman M, Marraffa JM, Wojcik S, Grant W. Serum Calcium Concentration in Ethylene Glycol Poisoning. J Med Toxicol. 2017;13(2):153-157. doi:10.1007/s13181-017-0598-4
  13. Badan Pengawas Obat dan Makanan - Republik Indonesia.html.
  14. Rosen R, Robbins-Juarez S, Stevens J. Ethylene Glycol Intoxication Requiring ECMO Support. Yegneswaran B, ed. Case Reports in Critical Care. 2021;2021:1-5. doi:10.1155/2021/5545351
  15. Miller H, Barceloux DG, Krenzelok EP, Olson K, Watson W. American Academy of Clinical Toxicology Practice Guidelines on the Treatment of Ethylene Glycol Poisoning. Journal of Toxicology: Clinical Toxicology. 1999;37(5):537-560. doi:10.1081/CLT-100102445
  16. Brent J. Fomepizole for Ethylene Glycol and Methanol Poisoning. N Engl J Med. 2009;360(21):2216-2223. doi:10.1056/NEJMct0806112
  17. Velez LI, Shepherd G, Lee YC, Keyes DC. Ethylene glycol ingestion treated only with fomepizole. J Med Toxicol. 2007;3(3):125-128. doi:10.1007/BF03160922
  18. Gardner TB, Manning HL, Beelen AP, Cimis RJ, Cates JMM, Lewis LD. Ethylene Glycol Toxicity Associated With Ischemia, Perforation, and Colonic Oxalate Crystal Deposition. J Clin Gastroenterol. 2004;38(5).
  19. Agerholm JS, Hansen KS, Voogd HL, Krogh AKH. Ethylene glycol toxicosis in milk-fed dairy calves. Acta Vet Scand. 2022;64(1):7. doi:10.1186/s13028-022-00626-1
  20. Moore MM, Kanekar SG, Dhamija R. Ethylene Glycol Toxicity: Chemistry, Pathogenesis, and Imaging. Radiology Case Reports. 2008;3(1):122. doi:10.2484/rcr.v3i1.122
  21. A Systematic Review of Ethanol and Fomepizole Use in Toxic Alcohol Ingestions - PMC.html.



DOI: https://doi.org/10.22146/jmpf.81552

Article Metrics

Abstract views : 1150 | views : 815

Refbacks

  • There are currently no refbacks.


Copyright (c) 2024 JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

©Jurnal Manajemen dan Pelayanan Farmasi
Faculty of Pharmacy
Universitas Gadjah Mada
Creative Commons License
View My Stats