Abstract
Lactic acidosis can be caused by a variety of pathological conditions. We present a case of recurrent ‘lactic’ acidosis, which was eventually diagnosed to be secondary to ethylene glycol poisoning. Though there are a handful of cases reported in the literature, it is not widely known that glycolic acid (a metabolite of ethylene glycol) is measured spuriously as lactic acid by some point of care analysers. Literature review would indicate that this is a rare but potentially confounding factor in diagnosis. Given the nature of the pathology, we would suggest that greater awareness of the problem is important.
[download-attachments container="div" style="list" dipslay_icon="1" display_count="1" display__size="0"]
References
- Barceloux D, Krenzelok E, Olson K, et al. (Ad Hoc Committee on the Treatment Guidelines for Ethylene Glycol Poisoning on Behalf of the American Academy of Clinical Toxicology). American Academy of Clinical Toxicology Practice Guidelines on the Treatment of Ethylene Glycol Poisoning. Journal of Clinical Toxicology 1999; 37(5): 537–560.
- Jacobsen D, McMartin KE. Antidotes for Methanol and Ethylene Glycol Poisoning. Journal of Clinical Toxicology 1997; 35(2): 127–143.
- Walder AD, Tyler CKG. Ethylene Glycol Antifreeze Poisoning. Three Case Reports and a Review of Treatment. Anaesthesia 1994; 57(5): 464–471.
- Woo MY, Greenway DC, Nadler SP, et al. Artifactual elevation of lactate in ethylene glycol poisoning. J Emerg Med 2003 Oct; 25(3): 289–93.
- Brindley PJ, Butler MS, Cembrowski J. 5 DN. Falsely elevated point-ofcare lactate measurement after ingestion of ethylene glycol. CMAJ 2007 Apr 10: 176(8): 1097–9.
- Singh M, Murtaza M, D’souza N, et al. Abdominal pain and lactic acidosis with ethylene glycol poisoning. Am J Emerg Med. 2001 Oct; 19(6): 529–30.
- Morgan TJ, Clark C, Clague A. Artifactual elevation of measured plasma L-lactate concentration in the presence of glycolate. Crit Care Med. 1999 Oct; 27(10): 2177–9.
- Porter WH, Crellin M, Rutter PW, et al. Interference by glycolic acid in the Beckman Synchron Method for lactate: a useful clue for unsuspected ethylene glycol intoxication. Clinical Chemistry 2000; 46: 874–5.
Request Permissions
To request copyright permission to republish or share portions of our works, please visit Copyright Clearance Center’s (CCC) Marketplace website by clicking the button below:
