Fatal Ethylene Glycol Intoxication

Clinical and forensic laboratories frequently have to face cases of severe intoxication from ethylene glycol, because of its wide availability, and thus its use as an additive in various housekeeping and commercial products such as anti-freezing agent, car batteries and solvents for dyes. The majority of ethylene glycol poisonings is related to suicide attempts (intentional ingestion) and to misguided or debilitated alcoholics (accidental ingestion or cheap substitute of alcohol) [1]. Ethylene glycol is metabolized to several toxic organic acids by alcohol and aldehyde dehydrogenases [2]. While EG itself exerts an acute depression of the central nervous system, glycolate and other acidic metabolites seem to be responsible for the acute toxic effects such as acidosis, hyperventilation, hypoxia, congestive heart failure, and acute respiratory distress syndrome [3,4]. Oxalate causes delayed renal failure due to precipitation of calcium oxalate crystals. After 24 hours, renal symptoms typically predominate, which if left untreated can lead to multiorgan failure and finally death [5]. We present case report of fatal EG-ingestion and the development of new GC/MS method for the quantification of this analyte, in order to illustrate the lethal potential of this common and widely available product.