Ethylene glycol serum osmolality

Table 58-2 lists the concentration and expected contribution to the serum osmolality in ethanol, methanol, ethylene glycol, and isopropanol poisonings. 

Early laboratory findings include a high serum osmolal gap from the ethylene glycol. An extreme metabolic acidosis with greatly elevated anion gap follows, principally from glycolic acid [100]. Hypocalcemia and hyperkalemia may be evident and urinalysis may reveal calcium oxalate crystalluria, hematuria, and proteinuria. 

Glasser DS. Utility of the serum osmol gap in the diagnosis of methanol or ethylene glycol ingestion. Ann Emerg Med 1996 27 343-6. 

B. Other useful laboratory studies include electrolytes, lactate, ethanol, glucose, BUN, creatinine, calcium, hepatic transaminases, urinalysis (for crystals and Wood s lamp examination), measured osmolality, arterial blood gases, and ECG monitoring. Serum beta-hydroxybutyrate levels may help distinguish ethylene glycol poisoning from alcoholic ketoacidosis, which may also cause increased anion and osmolar gaps. (Patients with alcoholic ke-... 

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