Fatal methanol intoxication with different survival times—Morphological findings and postmortem methanol distribution

Andresen, H.; Schmoldt, H.; Matschke, Jakob; Flachskampf, Frank A.; Türk, Elizabeth E.

doi:10.1016/j.forsciint.2008.05.014

Cited by 33 publications

(23 citation statements)

References 20 publications

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“…Also, the autopsy reports had not mentioned signs of pancreatitis and thus cannot be considered in our patients. In addition to that, few studies that reported the autopsy cases of methanol poisoning did not mention the pancreatic changes [32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Hyperglycemia Is a Strong Prognostic Factor of Lethality in Methanol Poisoning

et al. 2011

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Methanol poisoning is seen in the form of isolated episodes, or intentional ingestion and epidemics. Despite its efficient treatment, methanol poisoning has high morbidity and mortality rates. So far, several studies have been performed to identify the prognostic factors in methanol poisoning. Recently, during the treatment of patients with methanol poisoning, we observed that patients' blood glucose levels were high on presentation to the hospital, particularly in those who expired. Through a literature search, we found that no studies have been performed on blood glucose levels or hyperglycemia in methanol poisoning. Therefore, the present retrospective study was done as a preliminary investigation to understand whether there was a meaningful relationship between methanol poisoning and blood glucose level on presentation, and also if hyperglycemia could be considered as a prognostic factor for mortality. In this retrospective study, a review of the hospital charts was performed for all patients who were treated for methanol poisoning from March 2003 to March 2010 in two hospitals in Tehran, Iran. Those with definitive diagnosis of methanol poisoning, no history of diabetes mellitus, and normal or low body mass index (<25) were included. Patients' demographic information, clinical manifestations, time elapsed between ingestion and presentation, blood glucose level on presentation (before treatment), results of arterial blood gas analysis, and the clinical outcome were recorded. Statistical analysis was done using SPSS software (version 17, Chicago, Illinois, USA) and application of Mann-Whitney U test, Pearson's chi-square test, Pearson correlation coefficient (r), receiver operating characteristic (ROC) curve, and logistic regression. P values less than 0.05 were considered as the statistically significant levels. Ninety-five patients with methanol poisoning met the inclusion criteria and were included in the study. Of these, 91 (96%) were male and 4 (4%) were female. Mean age was 31.61 ± 14.3 years (range, 13 to 75). Among the 95 patients, 68 survived (72%) and 27 expired (28%). Median blood glucose level was 144 mg/dL (range, 75 to 500). There was no significant statistical correlation between blood glucose level and time of treatment, age, pCO(2), or serum bicarbonate concentration, but blood glucose level had a statistically significant correlation with pH (r = -0.242, P = 0.02) and base deficit (r = 0.230, P = 0.03). The mean blood glucose level was 140 ± 55 and 219 ± 99 mg/dL in the survivor and non-survivor patients, respectively (P < 001). Considering the cutoff level of 140 mg/dL for blood glucose and using logistic regression analysis, and adjusting according to the admission data with significant statistical difference in the two study groups, the odds ratio for hyperglycemia as a risk factor for death was 6.5 (95% confidence interval = 1.59-26.4). Our study showed that blood glucose levels were high in methanol poisoning and even higher in those who died in comparison with the survivors. Therefore, ...

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Section: Discussionmentioning

confidence: 99%

Hyperglycemia Is a Strong Prognostic Factor of Lethality in Methanol Poisoning

et al. 2011

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“…Initial serum methanol concentrations on admission of 6877 mg/L were very high; in fact, only two cases with higher serum methanol levels have been reported [11,12], but in spite of that, no damage in the brain was found apart for mild microscopic oedema. This is in accordance with other authors who believe that only patients surviving more than 24 h show the characteristic nervous findings [7,[13][14][15].…”

Section: Discussionmentioning

confidence: 90%

Severe necrosis of oesophageal and gastric mucosa in fatal methanol poisoning

Cascallana¹,

Gordo²,

Montes³

2012

Forensic Science International

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“…In contrast, handmade alcoholic drinks contain high levels of methanol, which can lead to poisoning. Most of the patients survive, but some cases result in death, which cannot be even prevented using intensive care, dialysis, and treatment with antidotes (2).…”

Section: Introductionmentioning

confidence: 99%

Survey On Methanol Poisoning Epidemic in Rafsanjan City in Year 2013

Mirzaee

Riahi

Sharifzadeh

et al. 2017

IMMINV

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Background: Examination and early detection of the methanol toxicity epidemic are very important, so identification and initiation of appropriate therapy can significantly reduce morbidity and mortality. Therefore, this study was aimed to investigation methanol poisoning epidemic in Rafsanjan city. Methods: This case series study was conducted in 252 patients with methanol poisoning in 2013 in the Ali-ibn-Abi-Talib hospital of Rafsanjan. Data were through interviews and records that were collected at hospital admission. Due to the large number of patients and the possible lack of ability of rapid measurement of serum levels of methanol and need of rapid intervention, treatment to reduce any further complications, early diagnosis and treatment were carried out by clinical history and interpretation of arterial blood gas test results. Data record on provided checklists and then analyzed using SPSS version 19. Results: The mean pH was 0.13±7.27. The most frequent clinical features were visual disturbances (39.7%), dyspnea (1.2%), and gastrointestinal symptoms (7.1%). There was a trend towards decreasing PCO2 with decreasing pH amongst the patients surviving. The opposite trend was demonstrated in the dying; the difference was highly significant by linear regression analyses (P< 0.001). Conclusions: Methanol poisoning still has a high morbidity and mortality, mainly because of late diagnosis and treatment. Respiratory arrest, coma and severe metabolic acidosis upon admission were strong predictors of poor outcome. Early admission and ability of respiratory compensation of metabolic acidosis were associated with survival.

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Fatal methanol intoxication with different survival times—Morphological findings and postmortem methanol distribution

Cited by 33 publications

References 20 publications

Hyperglycemia Is a Strong Prognostic Factor of Lethality in Methanol Poisoning

Hyperglycemia Is a Strong Prognostic Factor of Lethality in Methanol Poisoning

Severe necrosis of oesophageal and gastric mucosa in fatal methanol poisoning

Survey On Methanol Poisoning Epidemic in Rafsanjan City in Year 2013

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