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J Korean Soc Emerg Med > Volume 35(4); 2024 > Article
Journal of The Korean Society of Emergency Medicine 2024;35(4): 330-334.
검사장비 간 혈중젖산농도의 차로 진단된 에틸렌글리콜 중독 1례
하유라1 , 최유리1,2 , 정진우1,2 , 한미호3
1동아대학교병원 응급의학과
2동아대학교 의과대학 응급의학교실
3동아대학교병원 중환자의학과
A case of ethylene glycol poisoning accompanied by a lactate gap between analyzing methods
Yura Ha1 , Yuri Choi1,2 , Jinwoo Jeong1,2 , Miho Han3
1Department of Emergency Medicine, Dong-A University Hospital, Busan, Korea
2Department of Emergency Medicine, Dong- A University College of Medicine, Busan, Korea
3Department of Critical Care Medicine, Dong-A University, Busan, Korea
Correspondence  Yuri Choi ,Tel: 051-240-5590, Fax: 051-240-5309, Email: yurichoi@dau.ac.kr,
Received: September 25, 2023; Revised: February 17, 2024   Accepted: March 5, 2024.  Published online: August 30, 2024.
ABSTRACT
Ethylene glycol (EG) poisoning is highly lethal and difficult to diagnose. EG is metabolized through enzymatic reactions, producing glycolic acid, leading to high anion gap acidosis. The authors report a case wherein EG poisoning produced a large lactate gap between the two measuring methods. A 33-year-old male presented to the emergency department with an altered level of consciousness. The lactate levels measured using a point-of-care test (POCT) revealed severe lactic acidosis. The POCT lactate level corresponded to the amount of anion gap. Follow-up tests in the intensive care unit revealed a serum lactate level of 1.91 mmol/L, while the arterial POCT test yielded 28.1 mmol/L. Based on the lactate gap observed between the two methods, the possibility of EG poisoning was re-considered. EG poisoning was later confirmed by detecting EG in the patient’s system. Thus, EG poisoning should be considered when there is a severe lactate gap between the measuring methods.
Key words: Ethylene glycols; Point-of-care testing; Lactic acid; False positive reactions
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