Fomepizole treatment of ethylene glycol poisoning in an infant.

Abstract:

:The enzyme alcohol dehydrogenase metabolizes ingested ethylene glycol (EG) to the toxic compounds glycolic and oxalic acids. Renal failure, acidosis, hypocalcemia, and death may follow. Traditional treatment of EG poisoning may require ethanol, a competitive substrate of alcohol dehydrogenase, and hemodialysis, that removes both EG and its toxic metabolites. A new alcohol dehydrogenase inhibitor, fomepizole (4-methylpyrazole), was approved in 1997 for patients at least 12 years old with suspected or confirmed EG poisoning. Fomepizole has not been studied adequately in the pediatric population. We present a case of an 8-month-old male infant who drank up to 120 mL of EG and developed acidosis and oxalate crystalluria. He was treated with fomepizole and hemodialysis. Even after the completion of hemodialysis, fomepizole appeared to effectively block the production of EG toxic metabolites and to allow the resolution of acidosis; the patient recovered within 48 hours. This is the first report of fomepizole treatment of EG poisoning in an infant.4-methylpyrazole, fomepizole, poisoning, ethylene glycol, hemodialysis, infant, child, pediatrics.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Baum CR,Langman CB,Oker EE,Goldstein CA,Aviles SR,Makar JK

doi

10.1542/peds.106.6.1489

subject

Has Abstract

pub_date

2000-12-01 00:00:00

pages

1489-91

issue

6

eissn

0031-4005

issn

1098-4275

journal_volume

106

pub_type

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