Unusual case of methanol poisoning

Journal Article · Sat Jan 09 00:00:00 EST 1993 · Lancet; (United States)

DOI:https://doi.org/10.1016/0140-6736(93)92587-J· OSTI ID:6396381

Shapiro, L; Henderson, M ^[1]; Madi, S; Mellor, L ^[2]

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1. St. James's Univ. Hospital, Leeds (United Kingdom). Dept. of Chemical Pathology
2. St. James's Univ. Hospital, Leeds (United Kingdom). Dept. of Medicine, and Pharmacy

A 31-year-old man with a history of alcohol abuse presented to the accident and emergency department complaining of blurred vision. 4 h previously he had drunk 300 mL de-icer fluid. Electrolytes, urea, creatinine, glucose, and blood-gas analysis were normal. Measured osmolality, however, was 368 mosmol/kg with a calculated osmolality of 300 mosmol/kg, which indicated a greatly increased osmolar gap. He was therefore given 150 mL whisky and admitted. Methanol was later reported as 200 mg/dL. Ethylene glycol was not detected, but another glycol, propylene glycol, was present at 47 mg/dL. 10 h after ingestion an intravenous infusion of ethanol was started and he was hemodialysed for 7 h. After dialysis he was given a further 100 mL whisky and the rate of ethanol infusion was reduced to 11 g per h. Methanol and ethanol were measured twice daily until methanol was under 10/mg/dL: The recommendation is that blood ethanol be maintained between 100 and 200 mg/dL during treatment of methanol poisoning. This concentration was not achieved, presumably because of the high rate of ethanol metabolism often found in alcoholics. Antifreeze solutions commonly contain methanol and ethylene glycol. Sometimes propylene glycol is substituted because it has properties similar to those of ethylene glycol but is less toxic. The authors postulate that propylene glycol inhibited the metabolism of methanol in the patient, thus sparing him from the toxic effects of methanol.

• OSTI ID: 6396381
• Journal Information: Lancet; (United States), Vol. 341:8837; ISSN 0099-5355
• Country of Publication: United States
• Language: English

Related Subjects

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ETHANOL
BIOLOGICAL EFFECTS
METHANOL
TOXICITY
BLOOD CHEMISTRY
MAN
METABOLISM
POLYETHYLENE GLYCOLS
ALCOHOLS
ANIMALS
BIOCHEMISTRY
CHEMISTRY
GLYCOLS
HYDROXY COMPOUNDS
MAMMALS
ORGANIC COMPOUNDS
ORGANIC POLYMERS
POLYMERS
PRIMATES
VERTEBRATES
560300* - Chemicals Metabolism & Toxicology