La semaine des hopitaux : organe fonde par l'Association d'enseignement medical des hopitaux de Paris

[Acute human and experimental poisoning with diethylene glycol].

PMID 6302869


Although acute poisoning with ethylene glycol (EG) used in antifreeze mixtures is well known in man, only a few reports have described acute intoxication with diethylene glycol (DEG) and only one has mentioned oxaluria. Furthermore, there is no experimental evidence that DEG is metabolized into oxalate. The ability of ethanol infusions to prevent hepatic oxidation of DEG has not been proved. Moreover, failure of this treatment has been reported by some authors. In order to resolve such questions, Wistar male adult rats possessing a hepatic alcohol deshydrogenase were given a single oral dose of 15 ml/kg-1 DEG. Rats were either untreated or treated with hydration alone or associated with bicarbonate or ethanol. Urinary output, urinary oxalate excretion, acid-base balance in peripheral blood and renal histology were studied. Acute poisoning induced metabolic acidosis, polyuria, hyperoxaluria with renal tubular necrosis and a 66% mortality. Massive hydration improved acidosis and prognosis, but mortality and renal lesions were avoided only when bicarbonate or ethanol were added. Only ethanol significantly decreased oxaluria. In acute DEG poisoning, both the mechanism and the treatment appear to be the same as in acute EG intoxication.