Two Cases of Ethylene Glycol Poisoning Treated Successfully with Haemodialysis

Introduction: ethylene glycol is an organic toxic compound found in many household items including radiator coolants and brake oil.toxic effects of ethylene glycol are due to its metabolites glycolic acid and oxalic acid which cause potentially fatal metabolic acidosisand renal failure. here we discuss two cases of ethylene glycol poisoning with literature review on pathophysiology, clues in diagnosisand therapy.case presentations: first case is of a teenage girl presenting with unexplained persistent drowsiness. she went on to develop acidoticbreathing and anuria. unexplained metabolic acidosis and acute kidney injury inclined us towards ethylene glycol poisoning. onfurther questioning, she confirmed taking radiator coolant 5 hours before admission.the second case is of a young automobile serviceman who presented with unexplained markedly reduced level of consciousness. hehad high anion gap metabolic acidosis, calcium oxalate crystals in urine and basal ganglia hypodensities in non-contrast ct. he laterdeveloped acute kidney injury. ethylene glycol poisoning was suspected which was later confirmed when the patient regainedconsciousness.both patients responded well to haemodialysis and recovered without complications.discussion: ethylene glycol is an easily accessible toxic compound that can be used as a suicidal agent. high anion gap metabolicacidosis, acute kidney injury, calcium oxalate crystalluria and altered sensorium are highly suggestive.conclusions: a high degree of suspicion is needed for early diagnosis. haemodialysis can be used effectively to remove the toxicmetabolites and treat the renal impairment. early recognition will save lives without long term renal or neurologic complications.