A 32 year old lethargic male was brought to emergency depament with history of consumption of some drug .On investigation, he had low calcium, serum Creatinine -3.8 mg/dL, raised BUN . On ABG, metabolic acidosis was noted. On urine examination, calcium oxalate crystals were observed. He was treated with 4-methyl pyrazole. What could be the probable drug ingestion leading to following condition ?
ETHYLENE GLYCOL It is a clear, colourless, odourless, non-volatile liquid with a bitter-sweet taste. It is mainly used as an antifreeze agent and not absorbed through skin. SYMPTOMS: Initial symptoms are vomiting, lethargy, ataxia, inebriation, convulsions and coma. In 12 to 24 hours tachycardia, tachyapnoea and circulatory collapse, electrolyte imbalance and metabolic acidosis occur. In one to three days, hypocalcaemia, oliguria, tubular necrosis and renal failure occur. Urine contains crystals of calcium oxalate. FATAL DOSE: 100 ml TREATMENT: Gastric lavage. Activated charcoal. Ethanol in same dose as for methyl alcohol. 4-methyl pyrazole -Fomipezole (Alcohol Dehydrogenase inhibitor). Haemodialysis. I.v. sodium bicarbonate.
Methyl alcohol
Paraldehyde
Formaldehyde
Ethylene glycol
Toxicology - 1