Öz
Etilen Glikol (EG) ilk kez 1859 yılında Fransız kimyager Charles
Wurtz tarafından hazırlanmış, C2H6O2 formülüne
sahip, saf halde kokusuz, renksiz, berrak, uçucu olmayan, tatlı, şurup
kıvamında ve sıvı şeklinde bir alkoldür. EG kendisi toksik olmasa da,
metabolitleri toksik olan bir alkoldür. EG’un %95’lik solusyonunun bir erişkin
için minimum letal dozu, vücut ağırlığı esas alınarak 1.4 ml/kg olarak kaydedilmektedir.
Bu çalışmada EG’e bağlı akut böbrek yetmezliği (ABY) gelişmiş bir olgu sunuldu.
81 yaşında erkek hastanın yanlışlıkla birkaç yudum antifriz içmesi sonrası
görülen koma hali, ciddi metabolik asidoz ve akut böbrek yetmezliği (ABY)
tablosu gelişen hastada antidot olarak fomepizol kullanıldı. Hasta yoğun
bakım tedavisi sonrası nefroloji
servisine devir edildi.
Anahtar Kelimeler
Kaynakça
- Aşırdizer M ve ark. Toksikolojik, Klinik ve Adli Tıp Yönleriyle Etilen Glikol Zehirlenmesi Türkiye Klinikleri J Foren Med 2010;7(2)
- Caravati EM, Erdman AR, Christianson G, et al. Ethylene glycol exposure: an evidence based consensus guideline for out of hospital management. Clin Toxicol (Phila), 2005. 43(5): p. 327-45.
- Armstrong EJ, Engelhart DA, Jenkins AJ, Balraj EK. Homicidal ethylene glycol intoxication: a report of a case. Am J Forensic Med Pat hol 2006;27(2):151-5.
- U.S. Department of Health and Human Services & Public Health Service. Draft toxicological profile for ethylene glycol. Draft toxico logical profile for ethylene glycol. Atlanta: Agency for Toxic Substances and Disease Registry; 2007. p.1,21,29,36,47.
- Toxic Exposure Surveillance System (TESS) .Washington, DC: American Association of Poison Control Centers, 2004. Database accessed May 2004.
- Demirel İ, Avcı L, Atalan G, Urfalıoğlu A, Toprak GÇ. Antifiriz İçen Bir Hastada Etilen Glikol Zehirlenmesi: Olgu Sunumu. Fırat Tıp Dergisi 2012;17(3):182-184.
- Patocka J, Hon Z. Ethylene Glycol, Hazardous Substance İn The Household. Acta Medica 2010;53(1):19-23.
- Davis DP, Bramwell KJ, Hamilton RS, Williams SR. Ethylene glycol poisoning: case report of a record high level and a review. J Emerg Med 1997; 15: 653-67.
- Khan SR, Glenton PA, Byer KJ. Modeling of hyperoxaluric calcium oxalate nephrolithiasis: experimental induction of hyperoxaluria by hydroxy L proline. Kidney Int 2006; 70: 914-23
- Linden CH, Lovejoy FH. Poisoning and drug overdosage. In: Fauci A, Braunwald E, Isselbacher K, Wilson J, Martin J, eds. Harrison's Principles of Internal Medicine. 14th ed. New York: The Mc Graw Hill Companies; 1998. p.2534-35.
- Henderson WR, Brubac her J. Methanol and ethylene glycol poisoning: a case study and review of current literature. CJEM 2002;4(1): 34-40.
- Caravati EM, Heileson HL, Jones M. Treatment of severe pediatric ethylene glycol intoxication without hemodialysis. J Toxicol Clin Toxicol 2004; 42:255 – 259.
- Buchanan JA, Alhelail M, Cetaruk EW, Schaeffer TH, Palmer RB, Kulig K, et al. Massive ethylene glycol ingestion treated with fomepizole alone-a viable therapeutic option. J Med Toxicol 2010;6(2):131-4.
- Brent J. Fomepizole for the treatment of pediatric ethylene and diethylene glycol, butoxyethanol, and methanol poisonings. Clin Toxicol (Phila) 2010;48(5):401-6.
- Wallman P, Hogg K. To wards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Management of acute ethylene glycol poisoning. Emerg Med J 2002;19(5):431-2.
Öz
SUMMARY
First discovered
by French chemist Charles Wurtz in 1859, ethylene glycol (EG) is a liquid
alcohol which is odorless in its pure form, colorless, non-volatile, sweet in
taste, syrup in consistency with its chemical formula being C2H6O2.
Although it is not toxic, it is an alcohol of which metabolites are toxic.
Minimal lethal dose of 95% solution of EG for an adult has been reported as 1.4
ml/kg based on body weight. A case report was presented in this study who
developed acute renal failure (ARF) due to EG. Fomepizole was used as antidote
in 81 years old male patient presenting with coma, serious metabolic acidosis,
and ARF following accidental ingestion of a few drops of antifreeze. The
patient was referred to nephrology ward after treatment in the intensive care
unit.
Anahtar Kelimeler
Kaynakça
- Aşırdizer M ve ark. Toksikolojik, Klinik ve Adli Tıp Yönleriyle Etilen Glikol Zehirlenmesi Türkiye Klinikleri J Foren Med 2010;7(2)
- Caravati EM, Erdman AR, Christianson G, et al. Ethylene glycol exposure: an evidence based consensus guideline for out of hospital management. Clin Toxicol (Phila), 2005. 43(5): p. 327-45.
- Armstrong EJ, Engelhart DA, Jenkins AJ, Balraj EK. Homicidal ethylene glycol intoxication: a report of a case. Am J Forensic Med Pat hol 2006;27(2):151-5.
- U.S. Department of Health and Human Services & Public Health Service. Draft toxicological profile for ethylene glycol. Draft toxico logical profile for ethylene glycol. Atlanta: Agency for Toxic Substances and Disease Registry; 2007. p.1,21,29,36,47.
- Toxic Exposure Surveillance System (TESS) .Washington, DC: American Association of Poison Control Centers, 2004. Database accessed May 2004.
- Demirel İ, Avcı L, Atalan G, Urfalıoğlu A, Toprak GÇ. Antifiriz İçen Bir Hastada Etilen Glikol Zehirlenmesi: Olgu Sunumu. Fırat Tıp Dergisi 2012;17(3):182-184.
- Patocka J, Hon Z. Ethylene Glycol, Hazardous Substance İn The Household. Acta Medica 2010;53(1):19-23.
- Davis DP, Bramwell KJ, Hamilton RS, Williams SR. Ethylene glycol poisoning: case report of a record high level and a review. J Emerg Med 1997; 15: 653-67.
- Khan SR, Glenton PA, Byer KJ. Modeling of hyperoxaluric calcium oxalate nephrolithiasis: experimental induction of hyperoxaluria by hydroxy L proline. Kidney Int 2006; 70: 914-23
- Linden CH, Lovejoy FH. Poisoning and drug overdosage. In: Fauci A, Braunwald E, Isselbacher K, Wilson J, Martin J, eds. Harrison's Principles of Internal Medicine. 14th ed. New York: The Mc Graw Hill Companies; 1998. p.2534-35.
- Henderson WR, Brubac her J. Methanol and ethylene glycol poisoning: a case study and review of current literature. CJEM 2002;4(1): 34-40.
- Caravati EM, Heileson HL, Jones M. Treatment of severe pediatric ethylene glycol intoxication without hemodialysis. J Toxicol Clin Toxicol 2004; 42:255 – 259.
- Buchanan JA, Alhelail M, Cetaruk EW, Schaeffer TH, Palmer RB, Kulig K, et al. Massive ethylene glycol ingestion treated with fomepizole alone-a viable therapeutic option. J Med Toxicol 2010;6(2):131-4.
- Brent J. Fomepizole for the treatment of pediatric ethylene and diethylene glycol, butoxyethanol, and methanol poisonings. Clin Toxicol (Phila) 2010;48(5):401-6.
- Wallman P, Hogg K. To wards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Management of acute ethylene glycol poisoning. Emerg Med J 2002;19(5):431-2.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 15 Aralık 2018 |
| Gönderilme Tarihi | 18 Eylül 2018 |
| Kabul Tarihi | 26 Ekim 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 4 Sayı: 3 |
