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PEDIATRICS Vol. 102 No. 3 September 1998, p. e31

ELECTRONIC ARTICLE:
Ethylene Glycol Poisoning in a Child Treated With 4-Methylpyrazole

Received Nov 13, 1997; accepted May 4, 1998.

Patrick Harry*, Eric JobardDagger , Maryvonne Briand§, Alain Caubetparallel , and Alain TurcantDagger

From the * Centre Anti-poison, Centre Hospitalier Universitaire, Angers, France; Dagger  Laboratoire de Pharmacologie-Toxicologie, Centre Hospitalier Universitaire, Angers, France; § Service de Pédiatrie, Centre Hospitalier, Saint-Brieuc, France; and parallel  Centre Anti-poison, Centre Hospitalier Universitaire, Rennes, France.

Objective.  The alcohol dehydrogenase inhibitor 4-methylpyrazole (4-MP) is a new antidote of ethylene glycol (EG) intoxication. The purpose of the present case report was to demonstrate 4-MP efficiency in EG poisoning in a 4-year-old child.

Method and Results.  4-MP Treatment was performed 7 hours after EG ingestion. Plasma EG and 4-MP concentrations were measured 2 hours after each infusion of 4-MP. Plasma 4-MP concentrations were in the range of the values reported to block EG metabolism. The efficiency of 4-MP treatment was confirmed by the rapid correction of metabolic acidosis without alkalization and by the increase in EG half-life. No adverse effect of 4-MP was observed.

Conclusion.  This child ingested a potentially lethal dose of EG despite a high concentration of bittering agent in antifreeze. EG poisoning was treated efficiently by 4-MP without recourse to hemodialysis.  Key words:  4-methylpyrazole, ethylene glycol poisoning, denatonium benzoate.


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