Which body system is affected first by ethylene glycol poisoning?

Ethylene glycol poisoning primarily affects the neurological system first due to the metabolism of ethylene glycol into toxic metabolites. When someone ingests ethylene glycol, it is quickly absorbed into the bloodstream and converted in the liver into harmful substances such as glycolic acid and oxalic acid. These metabolites can have a profound impact on the central nervous system, leading to symptoms such as confusion, lethargy, and in severe cases, seizures or coma. This early manifestation of symptoms and the direct neurotoxic effects of ethylene glycol support the understanding that the neurological system is the first affected by this type of poisoning.

While other systems such as the renal and cardiopulmonary can also be significantly affected as the conditions of the patient progress, the immediate onset of neurological symptoms highlights the priority of the neurological system's involvement in ethylene glycol poisoning.