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종결 Case No. 356 2014-12-01~2014-12-31
출제자 : 최진욱 Hit : 352
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Period 2014-12-01~2014-12-31
Diagnosis Toxic encephalitis (ethylene glycol intoxication)
Clinical information M/16
C.C : Abnormal behavior
Laboratory findings imply anion gap acidosis
Discussion Ethylene Glycol Intoxication
 Clinical presentation
– Severe metabolic acidosis with increased anion gap / osmolar gap
– Calcium oxalate crystal in urine
– Final metabolite
– CNS, cardiopulmonary, and renal involvement
 Pathophysiology
– Metabolized in liver
– Intermediate metabolite glycolic acid
– Responsible for anion gap acidosis
– Cytotoxic effects
– Acidosis and hypoxia
 Imaging
On CT
 Low density change in bilateral basal ganglia
 Without mass effect
On MRI
 Increased T2 SI in bilateral basal ganglia and thalamus
– Amygdala, hippocampus, brain stem
 May show diffusion restriction
Reference,
Ethylene glycol toxicity: chemistry, pathogenesis and imaging. Radiology Case Reports (online) 2008; 3:122. radiologycasereports.com. DOI: 10.2484/rcr.2008.v3i1.122
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