IMAGES IN EMERGENCY MEDICINE
Calcium oxalate crystalluria
Eisenhower Army Medical Center, Fort Gordon, Georgia, USA
Correspondence to:
Correspondence to:
K H Waibel
Department of Medicine, Brooke Army Medical Center, Fort Sam, Houston, TX 78234, USA;kirk.waibel@se.amedd.army.mil
Accepted 8 April 2006
| The first 100% of the full text of this article appears below. |
A 42-year-old man presented with acute abdominal pain and nausea. The patient reported drinking about 650 ml of anti-freeze 24–36 h before presentation, in an attempt to commit suicide. Initial laboratory testing showed a pH of 7.25, an anion gap of 13 and an osmolar gap of 17. His blood urea nitrogen was 20 mg/dl and his creatinine concentration was 2.5 mg/dl. Microscopy of unspun urine under polarised light showed numerous clumps of calcium oxalate crystals, consistent with ethylene glycol toxicity (fig 1
). Treatment was initiated with high-dose pyridoxine, thiamine and an ethanol drip owing to unavailability of fomepizole at our institution.1 Over the next 9 days his creatinine peaked at 4.6 mg/dl, but gradually returned to normal without dialysis.
Figure 1 Calcium oxalate crystalluria.
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- Brent J. Current management of ethylene glycol poisoning. Drugs 2001;61:979–88.[CrossRef][Medline]
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