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
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Case Report

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

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


Figure 1.
Figure 1. Ethylene glycol metabolism.
Figure 2.
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.
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 1. Laboratory Values From the Initial Presentation to Until 24 H After Presentation
Initial presentationAt 2 hAt 4 hAt 8 hAt 12 hAt 15 hAt 18 hAt 24 h
pH (venous)
PCO214.610.0< 9.09.813.223.734.135.6
Base excess-28.0-26.9-21.5-18.3-
Sodium, serum (mmol/L)154150152152150145143140
Potassium, serum (mmol/L)
Chloride, serum (mmol/L)120114108109109107104105
Carbon dioxide, serum (mmol/L)755614242830
Blood urea nitrogen (mg/dL)2229313242455154
Serum creatinine (mg/dL)1.31.922.322.792.893.073.644.01
Serum calcium (mg/dL)9.910.510.
Serum anion gap273139372714115
Serum albumin (g/dL)
Serum phosphorus (mg/dL)
Glucose (mg/dL)132120124116
Lactate (mmol/L)5.816.867.8
Serum osmolality, calculated (mOsm/kg H2O)323322322314
Serum osmolality, measured (mOsm/kg H2O)352339330311
Serum ethyl alcohol (mg/dL)< 15