Citation

Loriaux D, Bergin SP, Patel SM, Tucker J, Barkauskas CE. Cureus 2019; 11(4): e4375.

Affiliation

Internal Medicine - Critical Care, Duke University Medical Center, Durham, USA.

Copyright

(Copyright © 2019, Curēus)

DOI

10.7759/cureus.4375

PMID

31218140

PMCID

PMC6553679

Abstract

Ethylene glycol (EG) poisoning is a toxicologic emergency requiring high clinical suspicion and early diagnosis to prevent life-threatening complications. Direct EG quantification methods involve cumbersome and time-consuming laboratory tests of limited utility in the emergency setting. Accordingly, the osmolal gap is frequently employed as a surrogate screening method in cases of suspected toxic alcohol poisoning. However, the osmolal gap has several inherent limitations to be considered when used as a diagnostic tool for EG toxicity. Although many of these limitations are widely acknowledged, the clinical finding of a normal serum osmolal gap in the setting of recurrent toxic alcohol exposure is an observation that has remained largely unexplored. The purpose of this case report is to characterize the accelerated osmolal gap to anion gap conversion that may occur in the setting of chronic toxic alcohol abuse.

Language: en

Keywords

ethylene glycol toxicity; osmolal gap