J Med Cases

Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc

Journal website https://www.journalmc.org

Case Report

Volume 13, Number 9, September 2022, pages 475-481

Polyethylene Glycol 3350 Crystal Nephropathy in Association With Glomerular Mesangial Immunoglobin A Deposition

Figures

Figure 1. Ethylene glycol metabolism.

Figure 2. Kidney biopsy. Light microscopy (H&E, 40 × 10) showed mesangial hypercellular glomerulus. Inset: mesangial IgA staining by immunofluorescence. H&E: hematoxylin and eosin; immunoglobulin A.

Figure 3. Kidney biopsy. Light microscopy (H&E, 20 × 10) showed proximal and distal tubules containing extensive yellowish-white, radially arranged crystals with cellular reaction (red arrows). Inset: birefringent crystals under polarization, consistent with calcium oxalate crystals. H&E: hematoxylin and eosin.

Table

**Table 1.** Laboratory Values From the Initial Presentation to Until 24 H After Presentation
	Initial presentation	At 2 h	At 4 h	At 8 h	At 12 h	At 15 h	At 18 h	At 24 h
pH (venous)	7.00	7.08	7.18	7.28	7.31	7.42	7.46	7.49
PCO₂	14.6	10.0	< 9.0	9.8	13.2	23.7	34.1	35.6
PO₂	55.0	112.0	131.0	80.2	60.3	46.5	179.0	172.0
Base excess	-28.0	-26.9		-21.5	-18.3	-7.8	1.1	3.9
Sodium, serum (mmol/L)	154	150	152	152	150	145	143	140
Potassium, serum (mmol/L)	4.7	4.6	3.8	3.3	3.3	3.3	3.4	3.3
Chloride, serum (mmol/L)	120	114	108	109	109	107	104	105
Carbon dioxide, serum (mmol/L)	7	5	5	6	14	24	28	30
Blood urea nitrogen (mg/dL)	22	29	31	32	42	45	51	54
Serum creatinine (mg/dL)	1.3	1.92	2.32	2.79	2.89	3.07	3.64	4.01
Serum calcium (mg/dL)	9.9	10.5	10.0	10.6	9.3	7.9	7.8	7.7
Serum anion gap	27	31	39	37	27	14	11	5
Serum albumin (g/dL)	3.9	3.7	3.5	3.4	3.3	2.9		2.7
Serum phosphorus (mg/dL)	5.8	4.2	3.1	2.9	2.6	3.3	5.8	6.1
Glucose (mg/dL)	132		120	124	116
Lactate (mmol/L)	5.81	6.86	7.8
Serum osmolality, calculated (mOsm/kg H₂O)	323		322	322	314
Serum osmolality, measured (mOsm/kg H₂O)	352		339	330	311
Serum ethyl alcohol (mg/dL)		< 15