Ethylene glycol poisoning commonly leads to which organ dysfunction?

• A. Acute kidney failure
• B. Hepatic failure
• C. Pulmonary fibrosis
• D. Neurologic only

Answer: (A)

Ethylene glycol poisoning most commonly causes acute kidney injury because its metabolites form calcium oxalate crystals that deposit in the renal tubules, leading to tubular damage and impaired kidney function. After ingestion, ethylene glycol is converted by alcohol dehydrogenase into glycolaldehyde, then glycolic acid and oxalic acid; the oxalic acid binds calcium to create calcium oxalate crystals that injure the kidney. While central nervous system symptoms and metabolic acidosis can occur, the kidney involvement is the hallmark and most common serious organ dysfunction in significant poisoning. Hepatic failure or pulmonary fibrosis are not the typical dominant manifestations, and saying neurologic only ignores the key renal injury.