Q: 36 year old male is admitted to ICU with severe metabolic acidosis. You suspect sepsis and ordered pan-culture. While reviewing lab you see that urine screen is reported with calcium oxalate crystals. What is your concern?


Answer: Ethylene glycol poisoning

Ethylene glycol’s major toxicity is a result of it’s metabolites: glycoaldehyde, oxalic acid, glycolic acid, and glyoxylate. Oxalic acid combines with calcium to form calcium oxalate crystals.