A young patient presented to casualty with a history of some substance abuse. His pulse was 130 beats per minute and respiratory rate was 30 per minute. Blood gas analysis revealed metabolic acidosis and his urea was 100 mg/dL and creatinine was 4 mg/dL. Urinalysis revealed calcium oxalate crystals. He improved symptomatically after management with intravenous fluids, gastric lavage, sodium bicarbonate, calcium gluconate and 4-methylpyrazole administration. What is the most likely substance that he consumed?

Explanation

Answer- C. Ethylene glycolInitial symptoms are vomiting lethargy, ataxia, inebriation, convulsions, and coma. In 12 to 24 hours tachycardia, tachypnoea and circulatory collapse, electrolyte imbalance and metabolic acidosis occur. In one to three days hypocalcemia, oliguria, tubular necrosis, and renal failure occur. Urine contains crystals of calcium oxalate.Ethylene glycol: Clear, colorless, odorless, non-volatile liquid with a bitter-sweet taste.Mainly used as an antifreeze agent; Not absorbed through the skin.Metabolized to glycolaldehyde, glycolic acid & oxalic acid and inhibits oxidative phosphorylationFatal dose: 100-200 ml; Fatal period:3 days