@article{ref1,
title="Massive Ethylene Glycol Poisoning Triggers Osmotic Demyelination Syndrome",
journal="Journal of emergency medicine",
year="2014",
author="Krasowski, Matthew D. and Engelman, Amy and Tschetter, Paul A. and Ahmed, Azeemuddin",
volume="46",
number="3",
pages="e69-74",
abstract="BACKGROUND: Ethylene glycol is a toxic organic solvent implicated in thousands of accidental and intentional poisonings each year. Osmotic demyelination syndrome (ODS) is traditionally known as a complication of the rapid correction of hyponatremia. OBJECTIVE: Our aim was to describe how patients with ethylene glycol toxicity may be at risk for developing ODS in the absence of hyponatremia. CASE REPORT: A 64-year old female patient was comatose upon presentation and laboratory results revealed an anion gap of 39, a plasma sodium of 150 mEq/L, a plasma potassium of 3.5 mEq/L, an osmolal gap of 218, an arterial blood gas pH of 7.02, whole blood lactate of 32 mEq/L, no measurable blood ethanol, and a plasma ethylene glycol concentration of 1055.5 mg/dL. The patient was treated for ethylene glycol poisoning with fomepizole and hemodialysis. Despite having elevated serum sodium levels, the patient's hospital course was complicated by ODS. CONCLUSIONS: Rapid changes in serum osmolality from ethylene glycol toxicity or its subsequent treatment can cause ODS independent of serum sodium levels.<p /><p>Language: en</p>",
language="en",
issn="0736-4679",
doi="10.1016/j.jemermed.2013.08.068",
url="http://dx.doi.org/10.1016/j.jemermed.2013.08.068"
}