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ML2015131 FATAL ETHYLENE GLYCOL INTOXICATION: A CASE REPORT
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SUMMARY
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 multiorgan 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.
Keywords: Ethylene glycol, intoxication, anatomopathology, suicide.