@article{ref1,
title="Massive ethylene glycol ingestion treated with fomepizole alone-a viable therapeutic option",
journal="Journal of medical toxicology",
year="2010",
author="Buchanan, Jennie A. and Alhelail, Mohammed and Cetaruk, Edward W. and Schaeffer, Tammi H. and Palmer, Robert B. and Kulig, Ken and Brent, Jeffrey",
volume="6",
number="2",
pages="131-134",
abstract="Fomepizole is used to treat and prevent toxicity from ethylene glycol poisoning. Treatment with fomepizole without hemodialysis in massive ethylene glycol ingestion has been rarely reported in the literature; however, published literature and practice guidelines recommend considering dialysis for ethylene glycol levels >50 mg/dL. We report a case of massive ethylene glycol ingestion resulting in the highest serum ethylene glycol concentration in a patient without ethanol co-ingestion who was treated with fomepizole and was not hemodialyzed. A 48-year-old male presented to the emergency department after reportedly ingesting >1 liter of antifreeze in an attempt at self-harm. He denied concomitant ethanol consumption. His initial presenting serum ethylene glycol level was 700 mg/dL, with normal renal function, and a metabolic acidosis with a high anion gap. One hour after presentation, he was started on intravenous fomepizole. Treatment with fomepizole continued until the patient's plasma ethylene glycol concentration was 16 mg/dL. His metabolic acidosis quickly resolved, he had no adverse reactions to the treatment, and his renal function remained normal. Ultimately, he was discharged to a psychiatric unit without sequelae. Published literature and practice guidelines suggests considering hemodialysis initiation in patients with an ethylene glycol level > 50 mg/dL. This recommendation is anecdotally, rather than evidence, based. With the potential risks inherent in hemodialysis, our case provides evidence that treatment with fomepizole without hemodialysis appears to be a viable alternative option in patients with even extremely high plasma ethylene glycol concentrations as long as their renal function is intact.<p /><p>Language: en</p>",
language="en",
issn="1556-9039",
doi="10.1007/s13181-010-0061-2",
url="http://dx.doi.org/10.1007/s13181-010-0061-2"
}