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Clinical Toxicology Volume 59, 2021 - Issue 8
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Clinical Research

Distinguishing between toxic alcohol ingestion vs alcoholic ketoacidosis: how can we tell the difference?

Emily T. Cohena Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, NY, USACorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0001-8044-2893
ORCID Icon,
Mark K. Sua Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, NY, USA;b New York City Poison Control Center, New York, NY, USAORCID Iconhttps://orcid.org/0000-0001-5211-5334
ORCID Icon,
Rana Biarya Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, NY, USA
&
Robert S. Hoffmana Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, NY, USAORCID Iconhttps://orcid.org/0000-0002-0091-9573
ORCID Icon
Pages 715-720 | Received 20 Jul 2020, Accepted 13 Dec 2020, Published online: 21 Jan 2021

References

  • Fomepizole. Lexicomp 2019.
  • Halpern NA. Critical Care Statistics: Society of Critical Care Medicine; [2020 Jun 22]. Available from: https://www.sccm.org/Communications/Critical-Care-Statistics.
  • Kearney J, Rees S, Chiang W. Availability of serum methanol and ethylene glycol levels: a national survey [abstract]. Clin Toxicol. 1997;35(5):509.
  • Jacobsen D, Hewlett TP, Webb R, et al. Ethylene glycol intoxication: evaluation of kinetics and crystalluria. Am J Med. 1988;84(1):145–152.
  • Brent J, McMartin K, Phillips S, et al. Fomepizole for the treatment of ethylene glycol poisoning. Methylpyrazole for Toxic Alcohols Study Group. N Engl J Med. 1999;340(11):832–838.
  • Casavant MJ, Shah MN, Battels R. Does fluorescent urine indicate antifreeze ingestion by children? Pediatrics. 2001; 107(1):113–114.
  • Parsa T, Cunningham SJ, Wall SP, et al. The usefulness of urine fluorescence for suspected antifreeze ingestion in children. Am J Emerg Med. 2005;23(6):787–792.
  • Hoffman RS, Smilkstein MJ, Howland MA, et al. Osmol gaps revisited: normal values and limitations. J Toxicol Clin Toxicol. 1993;31(1):81–93.
  • Fulop M, Hoberman HD. Alcoholic detosis. Diabetes. 1975;24(9):785–790.
  • Smith SW, Manini AF, Szekely T, et al. Bedside detection of urine beta-hydroxybutyrate in diagnosing metabolic acidosis. Acad Emerg Med. 2008;15(8):751–756.
  • Miller PD, Heinig RE, Waterhouse C. Treatment of alcoholic acidosis: the role of dextrose and phosphorus. Arch Intern Med. 1978;138(1):67–72.
  • Tanaka M, Miyazaki Y, Ishikawa S, et al. Alcoholic ketoacidosis associated with multiple complications: report of 3 cases. Intern Med. 2004;43(10):955–959.
  • Braden GL, Strayhorn CH, Germain MJ, et al. Increased osmolal gap in alcoholic acidosis. Arch Intern Med. 1993;153(20):2377–2380.
  • Schelling JR, Howard RL, Winter SD, et al. Increased osmolal gap in alcoholic ketoacidosis and lactic acidosis. Ann Intern Med. 1990;113(8):580–582.
  • Dillon ES, Dyer WW, Smelo LS. Ketone acidosis in nondiabetic adults. Med Clin N Am. 1940;24(6):1813–1822.
  • Jenkins DW, Eckle RE, Craig JW. Alcoholic ketoacidosis. JAMA. 1971;217(2):177–183.
  • Wrenn KD, Slovis CM, Minion GE, et al. The syndrome of alcoholic ketoacidosis. Am J Med. 1991;91(2):119–128.
  • McMartin KE, Ambre JJ, Tephly TR. Methanol poisoning in human subjects. Role for formic acid accumulation in the metabolic acidosis. Am J Med. 1980;68(3):414–418.
  • Jacobsen D, McMartin KE. Methanol and ethylene glycol poisonings. Mechanism of toxicity, clinical course, diagnosis and treatment. Med Toxicol. 1986;1(5):309–334.
  • Jacobsen D, Bredesen JE, Eide I, et al. Anion and osmolal gaps in the diagnosis of methanol and ethylene glycol poisoning. Acta Med Scand. 1982;212(1-2):17–20.
  • Jacobsen D, Ovrebo S, Ostborg J, et al. Glycolate causes the acidosis in ethylene glycol poisoning and is effectively removed by hemodialysis. Acta Med Scand. 1984;216(4):409–416.
  • Wu AH, McKay C, Broussard LA, National Academy of Clinical Biochemistry Laboratory Medicine, et al. National academy of clinical biochemistry laboratory medicine practice guidelines: recommendations for the use of laboratory tests to support poisoned patients who present to the emergency department. Clin Chem. 2003;49(3):357–379.
  • Hoffman RJ, Hoffman RS, Nelson LS. Ethylene glycol toxicity despite therapeutic ethanol level [abstract]. J Toxicol Clin Toxicol. 2001;39(3):302.
  • Beatty L, Green R, Magee K, et al. A systematic review of ethanol and fomepizole use in toxic alcohol ingestions. Emerg Med Int. 2013;2013:638057.

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