Kidney International's Whats your diagnosis section discusses a case of Diethylene glycol poisoning. ( image courtesy on left: Precious Body Fluids Blog)
Of all the alcohol poisonings, its important to distinguish which one you are dealing with. The article has a nice table that shows the similarities and differences of them.
Methanol poisoning usually has acute renal failure, met acidosis ( part of MUDPILES), and increased or normal osmolar gap; there is some neurological and visual disturbances.
Propylene glycol is usually seen with ativan drips, is seen with acute renal failure, metabolic acidosis and sometimes an osmolar gap but other findings are negative.
Ethylene glycol, another cause of metabolic acidosis and increased osmolar gap, you see with renal failure and + calcium oxalate crystals.
The Diethylene glycol poisoning is more rare but can happen as in this case. Its usually seen with acute renal failure, + metabolic acidosis and sometimes an osmolar gap but very frequently as noted in this article with neurological facial nerve pals and mild hepatitis.
Isopropyl alcohol is a classic one that has an elevated osmolar gap but no anion gap.
There is always something hiding in the gap. Even a low osmolar gap is abnormal.
take a look at this table I saw in Canadian medical association journal. I think that this table is a nice review.
Says it all.
Tuesday, March 2, 2010
- ► 2017 (37)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- ► 2011 (370)
- CLINICAL CASE 9
- The Online Transplant Center: Post transplant MPGN...
- Post transplant MPGN
- TOPIC DISCUSSION: PCO2, which one is better?
- Image Quiz- Answers
- CONSULT ROUNDS: METHANOL and the EYE?
- CONSULT ROUNDS: ACID BASE
- JOURNAL CLUB: Kidney allograft nephrectomy can imp...
- TOPIC DISCUSSION: Nutrition
- TOPIC DISCUSSION: Drugs and Cyclosporine
- IN THE NEWS- NSF and Kidney Transplantation
- Bowel Transplantations, not enough!
- Horseshoe Kidney
- The Online Transplant Center: New Agents for renal...
- CLINICAL CASE 8
- History of Nephrology: The first randomised contro...
- Common Sense vs. Evidence-based Medicine
- TOPIC DISCUSSION: DIFFERENT TYPES OF PROTEINURIA
- New Agents for renal transplantation
- TOPIC DISCUSSION: Renal Artery Stenosis
- TOPIC DISCUSSION: THE WWW and the NEPHROLOGIST
- IN THE NEWS- Hyperkalemia treatment in trouble
- IN THE NEWS ---> ACUTE KIDNEY INJURY
- CONSULT ROUNDS: SIADH and Escitalopram ( lexapro)...
- CONSULT ROUNDS: Clinical dilemma in Nephrogenic Di...
- CONSULT ROUNDS: Metformin toxicity, Lactic Acidosi...
- CLINICAL CASE 7
- IN THE NEWS- HgA1C for Diabetes Diagnosis. How abo...
- KIDNEY DONORS have Good Long term survival
- TOPIC DISCUSSION: VEGF Nephropathology
- TOPIC DISCUSSION: Post Transplant Collapsing FSGS,...
- Post Transplant Collapsing FSGS: Is it really all ...
- CLINICAL CASE 6
- Topic Discussion: OUCH!! Should Anesthesia Hurt?...
- TOPIC DISCUSSION: Alcohol Poisonings, gaps and osm...
- Belatacept approved by FDA
- Protocol Biopsies in Renal Allograft Recipients
- ▼ March (37)