Ethylene glycol poisoning
Ethylene glycol is found in antifreeze solution and diagnosis of poisoning can often be delayed as symptoms are similar to ethanol poisoning. Ethylene glycol poisoning can cause metabolic acidosis with a high anion and osmolar gap. The first line treatment is an alcohol dehydrogenase inhibitor, usually fomepizole. Ethanol can be used as a second line agent which also competitively inhibits alcohol dehydrogenase, thereby slowing the metabolism of ethylene glycol into its toxic metabolites. Haemodialysis can be used in refractory cases.
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