Ethylene Glycol Poisoning

To the Editor.— We read the recent case reports of massive ethylene glycol ingestion by Stokes and Aueron (1980;243:2065) and by Peterson et al.1Our own experience in a recent ethylene glycol poisoning, where the diagnosis was not evident from the patient's history and made only post mortem, caused us to review the clinical indications and available methods for ethylene glycol determination. A metabolic acidosis value with a high anion gap and a substantial discrepancy between the measured and calculated osmolality is suggestive of ethylene glycol or methyl alcohol intoxication. In either case, one must often start therapy with the infusion of ethyl alcohol, correction of the acidosis with sodium bicarbonate, and preparation for dialysis before there is laboratory confirmation. If a gas chromatograph is available for volatile toxins, a change in the usual screening conditions will include ethylene glycol among the identifiable poisons. As usually performed, volatile screens