Ethylene glycol poisoning classically presents with which finding?

• A. Kidney injury
• B. Visual disturbances
• C. Hypoglycemia
• D. Seizures

Answer: (A)

Ethylene glycol is metabolized to oxalic acid, which binds calcium to form calcium oxalate crystals that injure renal tubules. This crystal nephropathy leads to acute kidney injury, a classic and prominent finding in ethylene glycol poisoning. The picture also includes high anion gap metabolic acidosis and an osmolar gap, reflecting the glycol-containing compounds, but the kidney injury from calcium oxalate deposition is the hallmark feature. Visual disturbances are more typical of methanol poisoning, not ethylene glycol, and while seizures or hypoglycemia can occur, they are not defining presentations.