FATAL ETHYLENE GLYCOL INTOXICATION: A CASE REPORT

Abstract

Intentional, accidental or even criminal acute intoxication by ethylene glycol is a rare phenomenon in developed
countries. The severity of this intoxication is mainly due
to the hepatic metabolism of ethylene glycol which is
directly responsible for multi-organ failure. As the period
for first symptoms of poisoning ranges from 4 to 12h after
ingestion, most patients are initially admitted to hospital.
We report an original case of a woman discovered in a
forest in winter 3 days after her disappearance. A bottle
of antifreeze was found in her car. The autopsy revealed
severe multiorgan congestion. Toxicological analysis showed a lethal blood concentration of ethylene glycol (205
mg/l). Using histopathological techniques including polarized light, calcium oxalate monohydrate crystals were
found in autopsy samples from the brain, kidneys, myocardium, and the liver and urine cytology. To determine
the mechanism of death, we discuss both the hypothesis of
a sufficiently long agony period to explain the low toxic
ethylene glycol concentration in blood and the potential
role of hypothermia in the onset of death.