Methanol poisoning in Tunisia: Report of 16 cases

Brahmi, Nozha; Blel, Youssef; Abidi, Nour; Kouraichi, Nadia; Thabet, H.; Hédhili, Abderrazek; Amamou, M.

doi:10.1080/15563650701502600

Cited by 50 publications

(45 citation statements)

References 17 publications

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“…The outcome was related to the degree of metabolic acidosis, serum methanol concentration, coma upon admission, and the patient’s ability to hyperventilate 21. Furthermore, in another case series of 16 patients22 in Tunisia, a total of three (19%) patients who required mechanical ventilation because of deep coma or shock died within 6 hours. In a study by Verhelst et al,31 acute renal injury was found in 15 of the 25 (60%) patients.…”

Section: Discussionmentioning

confidence: 95%

Risk factors for mortality in Asian Taiwanese patients with methanol poisoning

Lee¹,

Chang²,

Lin³

et al. 2014

TCRM

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IntroductionMethanol poisoning continues to be a serious public health issue in Taiwan, but very little work has been done to study the outcomes of methanol toxicity in the Asian population. In this study, we examined the value of multiple clinical variables in predicting mortality after methanol exposure.MethodsWe performed a retrospective observational study on patients with acute poisoning who were admitted to the Chang Gung Memorial Hospital over a period of 9 years (2000–2008). Out of the 6,347 patients, only 32 suffered methanol intoxication. The demographic, clinical, laboratory, and mortality data were obtained for analysis.ResultsMost patients were middle aged (46.1±13.8 years), male (87.5%), and habitual alcohol consumers (75.0%). All the poisonings were from an oral exposure (96.9%), except for one case of intentionally injected methanol (3.1%). After a latent period of 9.3±10.1 hours, many patients began to experience hypothermia (50.0%), hypotension (15.6%), renal failure (59.4%), respiratory failure (50.0%), and consciousness disturbance (Glasgow coma scale [GCS] score 10.5±5.4). Notably, the majority of patients were treated with ethanol antidote (59.4%) and hemodialysis (58.1%). The remaining 41.6% of patients did not meet the indications for ethanol therapy. At the end of analysis, there were six (18.8%), 15 (46.9%), and eleven (34.4%) patients alive, alive with chronic complications, and dead, respectively. In a multivariate Cox regression model, it was revealed that the GCS score (odds ratio [OR] 0.816, 95% confidence interval [CI] 0.682–0.976) (P=0.026), hypothermia (OR 168.686, 95% CI 2.685–10,595.977) (P=0.015), and serum creatinine level (OR 4.799, 95% CI 1.321–17.440) (P=0.017) were significant risk factors associated with mortality.ConclusionThe outcomes (mortality rate 34.4%) of the Taiwanese patients subjected to intensive detoxification protocols were comparable with published data from other international poison centers. Furthermore, the analytical results indicate that GCS score, hypothermia, and serum creatinine level help predict mortality after methanol poisoning.

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Section: Discussionmentioning

confidence: 95%

Risk factors for mortality in Asian Taiwanese patients with methanol poisoning

Lee¹,

Chang²,

Lin³

et al. 2014

TCRM

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“…Alcohol can be produced using many different agricultural resources, and its illegal distribution is often highly visible in MMCs (e.g. Libya , Oman , Turkey , Tunisia and Indonesia ). Illegal homemade alcohol is strong and inexpensive, but if not made correctly can cause methanol poisoning .…”

Section: Challenges Facing Mmcsmentioning

confidence: 99%

Extent of alcohol prohibition in civil policy in Muslim majority countries: the impact of globalization

et al. 2015

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“…It is possible that a structural anatomic variation could provide one explanation for this discrepancy. We are aware of only one previous cursory mention of unilateral optic neuropathy from methanol poisoning [6] and present here, in more detail, this uncommon occurrence.…”

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confidence: 79%

Unilateral Blindness Following Acute Methanol Poisoning

Kalimullah

Bryant

2010

J. Med. Toxicol.

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A 47-year-old man with history of alcoholism presented to the emergency department with altered mentation and "blurry vision." He was tachypneic and minimally responsive to external stimuli, requiring endotracheal intubation. Vital signs were temperature 97.8°F, blood pressure 216/139, pulse 140/min, respiratory rate 26/min, and 98% oxygen saturation on room air. The pre-intubation venous pH was 6.79. Notable initial labs were sodium 135 mEq/L, potassium 3.7 mEq/L, chloride 95 mEq/L, total CO 2 4 mEq/L, blood urea nitrogen (BUN) 11 mg/dL, creatinine 1.7 mg/dL, anion gap 36, serum osmolality 361 mOsm/kg, ethanol <10 mg/dL. An ethanol infusion, NaHCO 3 drip, folic acid 1 mg, thiamine 50 mg, and pyridoxine 50 mg were initiated. The patient was dialyzed for 6 h until resolution of the anion and osmolar gaps. The initial methanol level was 123 mg/dL with a postdialysis level of 17 mg/dL. Ethylene glycol was undetectable. Following extubation, the patient, who had no prior ophthalmologic history and did not wear corrective lenses, was evaluated for persistent visual complaints. On exam, he had 20/20 acuity in the left eye, but only hand motion detection from the right eye. A right afferent pupillary defect and right optic disc pallor were also noted. Due to the unusual deficit, a magnetic resonance imaging (MRI) of the brain and orbits was obtained, revealing bilateral putaminal necrosis and edema at the retrobulbar and intracanalicular portions of only the right optic nerve (Fig. 1). MRI findings and cerebral spinal fluid (CSF) analysis did not provide alternative explanations for the ophthalmologic abnormalities. The patient was discharged on corticosteroids. On follow-up five months later, he had no visual improvement and remained ataxic and dysarthric. DiscussionAcute methanol poisoning characteristically causes metabolic acidosis as well as neurologic and ocular toxicity. The manifestations of ocular toxicity may vary, but commonlyThe authors have no declarations of interest to report.

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Methanol poisoning in Tunisia: Report of 16 cases

Cited by 50 publications

References 17 publications

Risk factors for mortality in Asian Taiwanese patients with methanol poisoning

Risk factors for mortality in Asian Taiwanese patients with methanol poisoning

Extent of alcohol prohibition in civil policy in Muslim majority countries: the impact of globalization

Unilateral Blindness Following Acute Methanol Poisoning

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