{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T16:32:08Z","timestamp":1773419528986,"version":"3.50.1"},"reference-count":17,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,2,28]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>Ethylene glycol toxicity poses a significant global health challenge, especially in low-income countries where it contaminates cough syrups. While global incidence is under-reported compared with the USA, mortality rates are much higher. In the USA, toxicity typically results from accidental ingestion. We report a man in his late 70s with hypertension who presented after being found unresponsive following a seizure. Laboratory findings showed severe anion gap metabolic acidosis with elevated osmolar gap, elevated lactate, acute kidney injury and urinary calcium oxalate crystals. Serum ethanol was &lt;10\u2009mg\/dL. Suspecting ethylene glycol ingestion, he received emergency treatment with fomepizole, thiamine, pyridoxine and haemodialysis. Ethylene glycol concentration was confirmed at 188\u2009mg\/dL (reference: 0\u2009mg\/dL) 3\u2009days postadmission. At a 2-month follow-up, his serum creatinine remained elevated. This case emphasises the critical importance of early recognition and rapid intervention in ethylene glycol toxicity to prevent severe complications and reduce long-term renal damage.<\/jats:p>","DOI":"10.1136\/bcr-2025-269235","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T14:20:18Z","timestamp":1773411618000},"page":"e269235","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Severe ethylene glycol toxicity leading to persistent kidney disease"],"prefix":"10.1136","volume":"19","author":[{"given":"Wenxia","family":"Lu","sequence":"first","affiliation":[{"name":"Medicine, Albert Einstein College of Medicine, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bishal","family":"Bharati","sequence":"additional","affiliation":[{"name":"Medicine, Albert Einstein College of Medicine, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhishesh","family":"Wagle","sequence":"additional","affiliation":[{"name":"Medicine, Albert Einstein College of Medicine, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Belinda","family":"Jim","sequence":"additional","affiliation":[{"name":"Medicine, Albert Einstein College of Medicine, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"2026031307200783000_19.3.e269235.1","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1080\/15563650.2023.2268981","article-title":"Annual Report of the National Poison Data System((R)) (NPDS) from America\u2019s Poison Centers((R)): 40th Annual Report","volume":"61","author":"Gummin","year":"2022","journal-title":"Clinical Toxicology Oct"},{"key":"2026031307200783000_19.3.e269235.2","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1056\/NEJMra1615295","article-title":"Toxic Alcohols","volume":"378","author":"Kraut","year":"2018","journal-title":"N Engl J Med"},{"key":"2026031307200783000_19.3.e269235.3","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2011.05.018"},{"key":"2026031307200783000_19.3.e269235.4","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfs009"},{"key":"2026031307200783000_19.3.e269235.5","doi-asserted-by":"publisher","DOI":"10.3109\/15563659209017942"},{"key":"2026031307200783000_19.3.e269235.6","doi-asserted-by":"crossref","first-page":"10693","DOI":"10.1021\/bi9003815","article-title":"Synthesis and evaluation of a novel class of G-quadruplex-stabilizing small molecules based on the 1,3-phenylene-bis(piperazinyl benzimidazole) system","volume":"48","author":"Jain","year":"2009","journal-title":"Biochemistry"},{"key":"2026031307200783000_19.3.e269235.7","first-page":"479","article-title":"Selected data of acute poisonings with ethylene glycol and methanol in Poland in the year 2010","volume":"70","author":"Swiderska","year":"2013","journal-title":"Prz Lek"},{"key":"2026031307200783000_19.3.e269235.8","doi-asserted-by":"crossref","unstructured":"Goga R , de Vasconcellos K , Singh D . Acute poisonings presenting to King Edward VIII hospital intensive care unit in Durban, South Africa. South Afr J Crit Care 2021;37. doi:10.7196\/SAJCC.2021.v37i1.408","DOI":"10.7196\/SAJCC.2021.v37i1.408"},{"key":"2026031307200783000_19.3.e269235.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2022.12.004"},{"key":"2026031307200783000_19.3.e269235.10","unstructured":"Organization WH . Diethylene Glycol (DEG) and Ethylene Glycol (EG) contamination - analytical methods developed for testing paediatric medicines. 2023. Available: https:\/\/www.who.int\/news\/item\/01-12-2023-diethylene-glycol-(deg)-and-ethylene-glycol-(eg)-contamination---analytical-methods-developed-for-testing-paediatric-medicines [Accessed 1 Dec 2023]."},{"key":"2026031307200783000_19.3.e269235.11","doi-asserted-by":"publisher","DOI":"10.1007\/BF01708094"},{"key":"2026031307200783000_19.3.e269235.12","doi-asserted-by":"crossref","DOI":"10.1186\/s13054-022-04227-2","article-title":"Extracorporeal treatment for ethylene glycol poisoning: systematic review and recommendations from the EXTRIP workgroup","volume":"27","author":"Ghannoum","year":"2023","journal-title":"Crit Care"},{"key":"2026031307200783000_19.3.e269235.13","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1080\/15563650.2022.2049810","article-title":"Treating ethylene glycol poisoning with alcohol dehydrogenase inhibition, but without extracorporeal treatments: a systematic review","volume":"60","author":"Beaulieu","year":"2022","journal-title":"Clin Toxicol (Phila)"},{"key":"2026031307200783000_19.3.e269235.14","doi-asserted-by":"publisher","DOI":"10.1081\/CLT-120006745"},{"key":"2026031307200783000_19.3.e269235.15","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1056\/NEJMoa2304820","article-title":"Effect of Hemodiafiltration or Hemodialysis on Mortality in Kidney Failure","volume":"389","author":"Blankestijn","year":"2023","journal-title":"N Engl J Med"},{"key":"2026031307200783000_19.3.e269235.16","doi-asserted-by":"publisher","DOI":"10.1258\/acb.2012.012052"},{"key":"2026031307200783000_19.3.e269235.17","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.061288"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269235","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T14:20:23Z","timestamp":1773411623000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269235"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":17,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,13]]},"published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1136\/bcr-2025-269235"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269235","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]}}}