Histopathological findings of medico-legal significance in delayed death from ethylene glycol poisoning

In ethylene glycol poisoning, the substance's toxicity is attributed to its metabolites, which are transformed in the body into calcium oxalate deposits. This case concerns a man who died five months after having attempted to commit suicide by swallowing an unknown quantity of ethylene glycol in the form of brake oil. The autopsy, ordered by the Judicial Authorities, revealed some interesting findings in the pericardium and visceral pleura. Chemical and toxicological tests were carried out on the bodily fluids and organs and proved negative of anything relevant, probably due to the time that had passed between the suicide attempt and the eventual death. Histopathological examination of the organs conducted using traditional techniques was the only technique that found signs of the previous poisoning, in the form of multiple microcalcifications of different sizes in various areas of the myocardium, glomeruli and renal tubules, associated with local necrosis of the renal parenchyma. The authors consider this case particularly interesting for its pathological/forensic profile, the rarity of this type of poisoning and the histopathological finding, at this later time, of calcium oxalate microcalcifications in the myocardium and kidneys, directly attributable to the harmful action of the ethylene glycol ingested five months earlier.