Brain MRI abnormalities in acute ethylene glycol poisoning: a case report

Autor: Jose Manuel Martinez Manzano, Karim O. Elkholy, Kevin Bryan Lo
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Toxicology Communications, Vol 6, Iss 1, Pp 74-77 (2022)
Druh dokumentu: article
ISSN: 24734306
2473-4306
DOI: 10.1080/24734306.2022.2087019
Popis: AbstractEthylene glycol (EG) is a toxic alcohol that causes central nervous system depression and multiple metabolic abnormalities including a high anion gap metabolic acidosis (HAGMA), elevated osmolal gap (OG), and acute kidney injury. Few case reports of EG intoxication report brain MRI findings. We describe an elderly female who was brought to the hospital because of altered mentation. We diagnosed her with EG toxicity and treated with fomepizole based on metabolic abnormalities and presence of urine calcium oxalate crystals. Our patient’s brain MRI showed T2-hyperintense signals located in the midbrain, hippocampi, basal nuclei, and thalami consistent with previous MRI reports with confirmed EG toxicity. As in this case, a clear history of poisoning is not always available. However, antidote therapy with alcohol dehydrogenase blockade should be initiated if clinical data suggests EG intoxication. Our patient’s EG concentration returned elevated two days after admission blood draw confirming the initial diagnosis. MRI of the brain may add diagnostic support to laboratory findings while awaiting a definitive EG concentration.
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