Serum Calcium Concentration in Ethylene Glycol Poisoning

J Med Toxicol. 2017 Jun;13(2):153-157. doi: 10.1007/s13181-017-0598-4. Epub 2017 Jan 12.

Abstract

Introduction: The diagnosis of ethylene glycol intoxication can be challenging. Definitive testing for ethylene glycol is not readily available and clinical decisions are often based on clinical suspicion and the results of more readily available tests. One of these findings is hypocalcemia, presumable through complexation with the ethylene glycol metabolite oxalate.

Methods: We performed a retrospective review of all patients admitted to a tertiary care hospital between 2005 and 2013 with laboratory confirmed ethylene glycol intoxication. Serum calcium on presentation was compared to blood gas pH on presentation as well as presentation serum bicarbonate.

Results: We did not find any relationship between calcium and serum pH either by linear regression or when dichotomized by pH ≥ or <7.3. We did observe an inverse relationship between serum calcium and bicarbonate.

Conclusions: Hypocalcemia is not commonly observed following ethylene glycol poisoning, even in acidotic patients.

Keywords: Anion gap metabolic acidosis; Ethylene glycol; Hypocalcemia; Toxic alcohol.

MeSH terms

  • Acid-Base Equilibrium / drug effects
  • Acidosis / blood
  • Acidosis / chemically induced
  • Acidosis / diagnosis
  • Adult
  • Bicarbonates / blood
  • Biomarkers / blood
  • Blood Gas Analysis
  • Calcium / blood*
  • Down-Regulation
  • Ethylene Glycol / poisoning*
  • Female
  • Humans
  • Hydrogen-Ion Concentration
  • Hypocalcemia / blood*
  • Hypocalcemia / chemically induced
  • Hypocalcemia / diagnosis
  • Male
  • Middle Aged
  • Poisoning / blood
  • Poisoning / diagnosis
  • Predictive Value of Tests
  • Retrospective Studies
  • Tertiary Care Centers

Substances

  • Bicarbonates
  • Biomarkers
  • Ethylene Glycol
  • Calcium