Evidence map›Paper›PMID 42593571›Full record

ArticleCEN case reports2026

Sequential changes in urinary crystal morphology in ethylene glycol poisoning: first human LV-SEM characterization of recovery-phase crystals.

Hiroki Ito, Takuo Hirose, Yuya Suzuki, Kentaro Yano, Risa Ishikawa, Tsubasa Yuki, Hideaki Hashimoto, Go Anan, Takashi Shimada, Hideya Itagaki and 3 more

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in CEN case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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0 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Hiroki ItoDivision of Nephrology and Hypertension, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan. hito@tohoku-mpu.ac.jp.ORCID 0000-0003-1239-6551
Takuo HiroseDivision of Nephrology and Hypertension, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan.
Yuya SuzukiDivision of Nephrology and Hypertension, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan.
Kentaro YanoDivision of Nephrology and Hypertension, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan.
Risa IshikawaDivision of Nephrology and Hypertension, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan.
Tsubasa YukiDivision of Nephrology and Hypertension, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan.
Hideaki HashimotoDivision of Nephrology and Hypertension, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan.
Go AnanDivision of Nephrology and Hypertension, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan.
Takashi ShimadaDivision of Emergency and Disaster Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Hideya ItagakiDivision of Emergency and Disaster Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Yoshinobu AbeDivision of Emergency and Disaster Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Tomoyuki EndoDivision of Emergency and Disaster Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Takefumi MoriDivision of Nephrology and Hypertension, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Ethylene glycol (EG) poisoning typically causes severe metabolic acidosis and acute kidney injury (AKI), characterized by urinary calcium oxalate (CaOx) crystals. Although needle-shaped calcium oxalate monohydrate (COM) crystals are a recognized diagnostic marker in the acute phase, sequential changes in urinary crystal morphology during recovery have not been well characterized in human cases. We present a 32-year-old man who developed profound metabolic acidosis (pH 6.747) and AKI (serum creatinine 1.56 mg/dL) after ingesting a lethal dose of EG. Following emergency hemodialysis and fomepizole treatment, urinalysis showed a sequential transition of urinary CaOx crystals from abundant needle-shaped COM in the acute phase to dumbbell-shaped COM and octahedral calcium oxalate dihydrate (COD) by day 14. This transition was observed during recovery, and renal function fully recovered by day 68 (serum creatinine 0.78 mg/dL). Low-vacuum scanning electron microscopy (LV-SEM) provided detailed three-dimensional visualization of these recovery-phase crystals after simple cytospin preparation, without chemical fixation or conductive coating. This report provides the first human LV-SEM visualization and characterization of recovery-phase urinary calcium oxalate crystals in ethylene glycol poisoning. These morphological changes may reflect recovery-related changes in the intratubular environment and offer pathophysiological insight into the transition from the acute toxic phase to recovery.

Indexed as

AcidosisAcute Kidney InjuryCalcium OxalateEthylene GlycolAdultCrystallizationCrystalluriaFomepizoleHumansMaleMicroscopy, Electron, ScanningRenal DialysisCalcium OxalateEthylene GlycolFomepizoleAcute kidney injuryCalcium oxalate crystalsEthylene glycolLV-SEM

Identifiers

PMID42593571
PMCPMC13473040

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.