A case of ethylene glycol poisoning accompanied by a lactate gap between analyzing methods
- Author:
Yura HA
1
;
Yuri CHOI
;
Jinwoo JEONG
;
Miho HAN
Author Information
1. Department of Emergency Medicine, Dong-A University Hospital, Busan, Korea
- Publication Type:Case Report
- From:Journal of the Korean Society of Emergency Medicine
2024;35(4):330-334
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Ethylene glycol (EG) poisoning is highly lethal and difficult to diagnose. EG is metabolized through enzymatic reactions, producing glycolic acid, leading to high anion gap acidosis. The authors report a case wherein EG poisoning produced a large lactate gap between the two measuring methods. A 33-year-old male presented to the emergency department with an altered level of consciousness. The lactate levels measured using a point-of-care test (POCT) revealed severe lactic acidosis. The POCT lactate level corresponded to the amount of anion gap. Follow-up tests in the intensive care unit revealed a serum lactate level of 1.91 mmol/L, while the arterial POCT test yielded 28.1 mmol/L. Based on the lactate gap observed between the two methods, the possibility of EG poisoning was re-considered. EG poisoning was later confirmed by detecting EG in the patient’s system. Thus, EG poisoning should be considered when there is a severe lactate gap between the measuring methods.