혈액투석으로 치유된 대사성산증을 보인 에틸렌 글리콜 중독 1예 = A Case of Ethylene Glycol Poisoning with Metabolic Acidosis Treated with Hemodialysis

다국어 초록 (Multilingual Abstract)

We present a case of ethylene glycol poisoning with high anion gap metabolic acidosis. A 71 year- old female patient was transferred to our hospital after ingesting 450 mL of anti-freeze. At arrival she showed high anion gap metabolic acidosis with pH 7.035, PaCO2 7.2 mmHg, PaO2 117.5 mmHg, HCO3－ 1.9 mmol/L and anion gap 32 mmol/L. Calcium oxalate crystals were identified on urine microscopy. Bicarbonate treatment did not improve her metabolic acidosis, and oliguric acute renal failure was developed. So she was treated with hemodialysis. After the hemodialysis treatment her metabolic acidosis was corrected and her renal function was improved. She was discharged on the 22nd day. (Korean J Nephrol 2005;24(6):1039-1043)

국문 초록 (Abstract)

부동액으로 흔히 사용되는 에틸렌 글리콜은 무색, 무취, 수용성으로 단맛이 나고 구강 점막에 대한 자극감이 거의 없어 외국에서는 “Sweet Killer”라고 불리기도 한다1). 에틸렌 글리콜 그 자체는 낮은 독성을 나타내지만 대사물질인 글리콜산 (glycolic acid)과 옥살산 (oxalic acid) 그리고 다른 유기산에 의해 독성이 발생한다2). 이 대사물은 경련과 혼수를 포함하는 심한 중추신경계 독성과 큰 음이온차를 가진 대사성산증, 그리고 심폐부전 및 급성 신부전으로 인해 치명적인 결과를 초래할 수 있어 신속한 진단과 적극적인 치료를 요한다. 이에 저자들은 치매가 있었던 71세 여자 환자에서 부동액 섭취 후 발생한 심한 대사성산증 및 급성 신부전이 합병된 에틸렌 글리콜 중독환자를 혈액투석으로 성공적으로 치료하였기에 문헌고찰과 함께 보고하고자 한다.

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