Value of glycolic acid analysis in ethylene glycol poisoning: A clinical case report and systematic review of the literature

Forensic Sci Int. 2018 Sep:290:e9-e14. doi: 10.1016/j.forsciint.2018.07.007. Epub 2018 Jul 17.

Abstract

Objective: To evaluate the clinical utility of glycolic acid (GA) determination in the diagnosis and prognosis of ethylene glycol (EG) intoxications.

Method: Systematic review of serum and/or urine GA concentrations available in the literature in cases of EG poisoning. Present a clinical case in which the determination of the GA was decisive.

Results: In total, 137 patients were included. Serum GA concentrations (but not EG) of patients who survive are different from those who die. The optimal cut-off of serum GA to predict mortality was 990.5mg/L (sensitivity 85.2%, specificity 54.3%) with an Odds Ratio of 6.838 (2.868-16.302). In our clinical case, serum EG was negative; however, urine GA was positive (1230.7mg/L).

Conclusions: In all suspected cases of EG poisoning, it is advisable to carry out the simultaneous analysis of EG and GA.

Keywords: Diagnosis; Ethylene glycol; Glycolic acid; Intoxication; Prognosis.

Publication types

  • Case Reports
  • Review
  • Systematic Review

MeSH terms

  • Biomarkers / blood
  • Biomarkers / urine
  • Ethylene Glycol / poisoning*
  • Gas Chromatography-Mass Spectrometry
  • Glycolates / blood*
  • Glycolates / urine*
  • Humans
  • Male
  • Middle Aged
  • Poisoning / diagnosis
  • Sensitivity and Specificity

Substances

  • Biomarkers
  • Glycolates
  • glycolic acid
  • Ethylene Glycol