Accidental methanol ingestion: Case report

Abstract

BackgroundThe incidence of methanol (CH3OH) intoxication differs enormously from country to country. Methanol intoxication is extremely rare in the Dutch population. Even a low dose can already be potentially lethal. Patients are conventionally treated with hemodialysis. Therefore we'd like to present a report of a foreign sailor in Rotterdam who accidentally caused himself severe methanol intoxication, with a maximum measured concentration of 4.4 g/L.Case presentationThe patient presented with hemodynamic instability and severe metabolic acidosis with pH 6.69. The anion gap was 39 mmol/L and the osmol gap 73 mosmol/kg. Treatment with ethanol and continuous venovenous hemodiafiltration (CVVH-DF) was initiated. Despite the hemodynamic instability it is was possible to achieve rapid correction of pH and methanol concentration with CVVH-DF while maintaining a stable and therapeutic ethanol serum concentration. Despite hemodynamic and acid-base improvement, our patient developed massive cerebral edema leading to brain death. Permission for organ donation was unfortunately not ascertained.ConclusionsWe conclude that in a hemodynamic instable situation high methanol concentrations and methanol-induced derangements of homeostasis are safely and effectively treated with CVVH-DF and that severe cerebral edema is another possible cause of death rather than the classical bleeding in the putamen area.

A systematic review of the epidemiology of unrecorded alcohol consumption and the chemical composition of unrecorded alcohol

“…The overwhelming majority of these deaths are due to ethanol. Deaths due to methanol poisoning as reported in the published literature account for fewer than 1000 deaths in any given year ( in addition to the methanol deaths in India reported above). Publications on methanol deaths stem from three sources: case studies (e.g.…”

“…Publications on methanol deaths stem from three sources: case studies (e.g. ), studies about outbreaks (e.g. ) and systematic analyses of all deaths to intoxication in a region (e.g.…”

Magnitud y características de la intoxicación por alcohol metílico. Hospital Nacional Dos de Mayo

“…En nuestra serie la edad promedio fue de 40,08 (DE+11,24). La proporción encontrada respecto al sexo masculino en relación al femenino fue de 3:1, esta predominancia del género masculino fue reportada en diferentes series de otros países (12)(13)(14) , esta característica podría estar relacionada a la mayor proporción de varones con dependencia alcohólica y su contacto más frecuente en sus actividades laborales con productos tóxicos industriales que contienen metanol.…”

“…Este hallazgo contrasta con estudios realizados en otros países en donde el nivel socioeducativo es diferente y predominan ocupaciones como pescadores, marineros, barnizadores, carpinteros, entre otros (8,(12)(13)(14) .…”

The Importance of the Ionic Product for Water to Understand the Physiology of the Acid-Base Balance in Humans

“…Intoxication by some alcohols, including ethanol [ 73 , 80 ], methanol, [ 83 ], and propylene glycol [ 75 , 84 ] induces anion gap acidosis associated with L-lactic acidosis and accumulation of anions derived from alcohol metabolism, including ketone bodies (ethanol), formate (methanol), D-lactate (propylene glycol), and oxalate (ethylene glycol) [ 85 , 86 ].…”