Diethylene glycol (DEG) is an industrial chemical, the misuse of which has led to numerous epidemic poisonings worldwide. The mechanism of its toxicity has not been defined as to the precise relationship between the metabolism of DEG and target organ toxicity. The purpose of this study was to investigate the mechanism for the acute toxicity of DEG, and the effect of the alcohol dehydrogenase in...

We report a case of ethylene glycol poisoning in 70-year-old man with headache and dysarthria. Blood tests showed marked increase the anion gap (29.8 mOsm/kg) osmotic (14 mOsm/kg). The estimated blood concentration was 86.8 mg/dL. Ethanol administered he underwent haemodialysis for 7 cycles, which discontinued on day 12. Fomepizole, competes alcohol dehydrogenase, is an effective treatment pois...

Methanol is responsible for a life-threatening poisoning. Fomepizole, a potent alcohol dehydrogenase inhibitor, is an efficient and safe antidote that prevents or reduces toxic methanol metabolism. Although no study has compared its efficacy with ethanol, fomepizole is recommended as a first-line antidote. Treatment should be started as soon as possible, based on history and initial findings in...

S E P T E M B E R 2 0 1 4 , V O L . 7 2 , N O 7 © Van Zuiden Communications B.V. All rights reserved. To the Editor, We were very interested in the article by Rietjens et al. regarding antidotal therapies utilised in the treatment of ethylene glycol and methanol intoxication. We were especially interested in the cost analysis of ethanol versus fomepizole treatment. In the United States (US), th...

Ethylene glycol, a common antifreeze, coolant and industrial solvent, is responsible for many instances of accidental and intentional poisoning annually. Following ingestion, ethylene glycol is first hepatically metabolised to glycoaldehyde by alcohol dehydrogenase. Glycoaldehyde is then oxidised to glycolic acid, glyoxylic acid and finally oxalic acid. While ethylene glycol itself causes intox...

Objectives. The optimal antidote for the treatment of ethylene glycol or methanol intoxication is not known. The objective of this systematic review is to describe all available data on the use of ethanol and fomepizole for methanol and ethylene glycol intoxication. Data Source. A systematic search of MEDLINE and EMBASE was conducted. Study Selection. Published studies involving the use of etha...

Ethylene glycol toxicity can be fatal without prompt treatment. Treatment options may include ethanol, fomepizole, and intermittent hemodialysis (IHD). IHD is usually preferred; however, depending ...

Ethylene glycol is one of the most common toxic alcohol ingestions requiring hemodialysis for treatment. With the FDA approval in 1997 of fomepizole (4-methylpyrazole), the indications for hemodialysis in addition to fomepizole for ethylene glycol poisoning have been examined in recent articles and case reports. Fomepizole, a competitive inhibitor of alcohol dehydrogenase, binds to the same sit...

n engl j med 361;12 nejm.org september 17, 2009 1214 contribute to the discourse concerning the nuances of the clinical use of fomepizole. Rehman points out that the osmolal gap dissipates as ethylene glycol or methanol is metabolized. The reason is that only the parent compound contributes to this gap. Electroneutrality requires the acidic metabolites of ethylene glycol and methanol (primarily...