[From diagnostic uncertainty to therapeutic action in ethylene glycol poisoning].

Ethylene glycol (EG) is a toxic alcohol capable of causing potentially severe acute poisoning, primarily resulting from the accidental or intentional ingestion of antifreeze liquids. The clinical presentation involves neurological, renal, and systemic impairment, with metabolic acidosis and an elevated anion gap (AG). In some cases, EG is considered a differential diagnosis for severe metabolic acidosis with an elevated AG, as well as acute kidney injury. A characteristic finding is the presence of calcium oxalate crystals in the urine. Delayed diagnosis and treatment worsen the prognosis. This article presents three clinical cases managed at J. A. Fernández Hospital during the 2022-2024 period. All three cases involved neurological impairment of varying severity and metabolic acidosis with an elevated AG. All patients showed adequate tolerance to the treatment provided. The article highlights the diagnostic challenges posed by the limited availability of methods for EG measurement or detection in blood samples and outlines the various treatment options available.