DAG JACOBSEN, M.D., Ph.D.
To the editor: Gabow and coworkers (1), in their recent article, identify glycolate and lactate as the predominant acids causing the metabolic acidosis of ethylene glycol poisoning. They also show that hemodialysis with a bicarbonate dialysate is an efficient method for removal of glycolate and resolution of the acidemia. While both glycolate's contribution to the ethylene-glycol-induced acidosis and its dialysability have been described previously (2, 3), we question the role of lactate increases in this syndrome.
Experimental studies with rats, dogs, and monkeys as well as the evaluation of six intoxicated patients have not documented substantial lactate increases, and it
JACOBSEN D. Organic Acids in Ethylene Glycol Intoxication. Ann Intern Med. ;105:799–800. doi: 10.7326/0003-4819-105-5-799_3
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Published: Ann Intern Med. 1986;105(5):799-800.
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