A 29 year old man is brought to the emergency department after being found confused in a garage. He is tachypneic. Laboratory studies show an elevated anion gap metabolic acidosis, osmolar gap, and acute kidney injury. Urinalysis reveals envelope shaped crystals. Which of the following substances is the most likely cause of his renal injury?
- A)Calcium oxalate generated from ethylene glycol metabolismGABARITO
- B)Xanthine from allopurinol overdose
- C)Uric acid released during tumor lysis syndrome
- D)Cystine due to impaired renal reabsorption
- E)Magnesium ammonium phosphate from urease positive organisms
Explicação
Ethylene glycol is metabolized to glycolic and oxalic acids, producing an anion gap acidosis and calcium oxalate crystal deposition in the kidney. The combination of osmolar gap, AKI, and envelope shaped crystals is highly characteristic. Ver explicação completa e trilha adaptativa →