Published in Toxicology Communications ISSN 2473-4306 (Online) Publisher Taylor & Francis Group Country of publisher United Kingdom LCC subjects Medicine: Public aspects of medicine: Toxicology. MRI of the brain may add diagnostic support to laboratory findings while awaiting a definitive EG concentration. Our patient’s EG concentration returned elevated two days after admission blood draw confirming the initial diagnosis. However, antidote therapy with alcohol dehydrogenase blockade should be initiated if clinical data suggests EG intoxication. Given the nontoxic nature of this substance and historical significance as once the universal antidote for poisoning, primary care practitioners are urged. As in this case, a clear history of poisoning is not always available. A bezoar is solid mass of undigested food, plant fibers, or hair found in the digestive tracts of animals, including deer. Our patient’s brain MRI showed T2-hyperintense signals located in the midbrain, hippocampi, basal nuclei, and thalami consistent with previous MRI reports with confirmed EG toxicity. Bezoars have been used for centuries as antidotes to poisons. We diagnosed her with EG toxicity and treated with fomepizole based on metabolic abnormalities and presence of urine calcium oxalate crystals. We describe an elderly female who was brought to the hospital because of altered mentation. Few case reports of EG intoxication report brain MRI findings. AbstractEthylene glycol (EG) is a toxic alcohol that causes central nervous system depression and multiple metabolic abnormalities including a high anion gap metabolic acidosis (HAGMA), elevated osmolal gap (OG), and acute kidney injury.
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