Methanol poisoning in Turkey: Two outbreaks, a single center experience

Gülen, Müge; Satar, Salim; Avcı, Akkan; Acehan, Selen; Orhan, Ugur; Nazık, Hakan

doi:10.1016/j.alcohol.2020.07.002

Cited by 15 publications

(16 citation statements)

References 29 publications

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“…In our study, ethanol was administered to 81% (n=48) of the patients and fomepizole was administered to 19% (n=11) as an antidote. In a study conducted in our country, it was reported that 58% of the patients were treated with ethanol, and fomepizole was not used in any of the patients (14). In international studies, it has been reported that 80% of ethanol and 16% of fomepizole are used, quite similar to our study (15,16).…”

Section: Discussionsupporting

confidence: 86%

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Methanol poisoning in the emergency department: a retrospective study

Yurtsever

ARIKAN

Acar

et al. 2022

Journal of Health Sciences and Medicine

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Aim: Massive methanol poisonings have occurred in the past decades, resulting in a large number of deaths. In this study, our aim is to retrospectively analyze methanol poisoning cases admitted to the emergency department between 2019-2021, to evaluate their demographic characteristics, causes of poisoning, clinical and laboratory findings, treatments applied and mortality, and to contribute to the poisoning data of our country. Material and Method: The cases of methanol poisoning who applied to the emergency department in a 3-year period were analyzed retrospectively. Medical files of patients aged 18 years and older were reviewed. Patients diagnosed with 'methanol poisoning' as a result of the examination were included in the study. Results: A total of 59 patients were included in the study. 88% (n=52) of the patients with a mean age of 53±10 were male. The presence of neurological symptoms and GCS were associated with mortality among the symptoms of patients presenting to the emergency department (p=0.017, p

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Section: Discussionsupporting

confidence: 86%

“…In our study, the mortality rate was determined as 25.4% (n=15). This rate is similar to the studies conducted in Turkey (7,14), but it is considerably higher than the studies conducted abroad (10,11,15). Such a high mortality rate may be related to the number of patients who need hemodialysis and mechanical ventilation.…”

Section: Discussionsupporting

confidence: 86%

Methanol poisoning in the emergency department: a retrospective study

Yurtsever

ARIKAN

Acar

et al. 2022

Journal of Health Sciences and Medicine

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“…Methyl alcohol, which is cheaper in cost than ethyl alcohol, is a toxic type of alcohol that has been used in the manufacture of illegal alcohol (smuggled alcohol, fake alcohol) recently and can cause death by causing very serious poisoning when consumed 1,2 . Methanol poisoning (MP) cases due to illicit alcohol consumption are encountered with increasing frequency in emergency services [2][3][4] .…”

Section: Introductionmentioning

confidence: 99%

“…Formic acid accumulation leads to high anion gap metabolic acidosis due to the formate's ability to inhibit mitochondrial respiration through its toxic effect on mitochondrial cytochrome c oxidase 6,7 . In MP cases, deep acidosis, increased anion gap, low HCO 3 -, high lactate, and hypercapnia are linked to a poor prognosis [1][2][3][4][5][6] . In addition, some prognostic factor research is ongoing.…”

Section: Introductionmentioning

confidence: 99%

Delta values as a prognostic marker in methanol poisoning: a retrospective cohort study

Duyan

SARIDAŞ

VURAL

2023

Cukurova Medical Journal

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Purpose: The aim of the study was to evaluate the mortality prediction performances of delta bicarbonate, delta anion gap, and delta ratio in methanol poisoning (MP) cases. Materials and Methods: This clinical study, which followed a cross-sectional study design, involved patients with MP who were still alive when they initially arrived at the emergency department of a tertiary care hospital. Patients were divided into two groups mortality and non-mortality. Patients who died during treatment and follow-up were assigned to the mortality group, while others were assigned to the non-mortality group. Receiver Operating Characteristic (ROC) analysis was used to determine the cut-off in the diagnostic value measurements of biomarkers predicting mortality. Results: Nine (20%) of the 45 patients in the study died during their follow-up. The two groups showed a significant difference in the averages of pH, bicarbonate (HCO3-), lactate, anion gap, delta anion gap, delta HCO3-, and delta ratio, but not in the averages of partial carbon dioxide pressure (pCO2). In predicting mortality, pH, anion gap, and delta anion gap were found to have outstanding diagnostic power (AUC>0.9), while HCO3-, delta HCO3-, delta ratio were found to have acceptable diagnostic power (AUC: 0.7-0.8). Conclusion: Delta anion gap, delta bicarbonate, and delta ratio can be used as prognostic factors in predicting mortality in MP cases.

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“…The exact dose causing pathological changes in the human visual system have not been precisely determined, and in most cases, it may depend on individual metabolic predisposition; however, it is known that consuming as little as 4 ml of methanol can lead to complete loss of vision (Bennett et al 1953 ). Massive outbreaks of toxic optic neuropathy (TON) associated with acute or chronic methanol poisoning occurred in the last century in the 1950s in the US (Bennett et al 1953 ; Benton and Calhoun 1953 ) and in the 1990s in Cuba (Lincoff et al 1993 ; Sadun et al 1994 ), as well as in recent decades in the El Salvador (Hassanian-Moghaddam et al 2015 ), Norway (Hovda et al 2005 ), Estonia (Paasma et al 2007 ), Czech Republic (Zakharov et al 2014 ), Libya (Rostrup et al 2016 ), Kenya (Rostrup et al 2016 ), Uganda (Doreen et al 2020 ), Turkey (Gulen et al 2020 ), India (Kumar et al 2019 ), and Tunisia (Brahmi et al 2007 ). Furthermore, in recent months, changes in social functioning caused by the COVID-19 pandemic have also contributed to a significant increase in the incidence of optic neuropathy related to methanol poisoning reported in various regions of the world including Iran (Khalili et al 2021 ; Sefidbakht et al 2020 ), as well as the US (Yip et al 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Methanol-induced optic neuropathy: a still-present problem

2022

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Methanol-induced optic neuropathy (Me-ION) is a serious condition that may result in long-term or irreversible visual impairment or even blindness secondary to damage and loss of function of the optic nerve and retina. Me-ION shows a tendency to occur as mass poisonings around the world with a clear predilection for poor societies in developing countries. The main mechanism underlying the molecular basis of Me-ION is the inhibition of the mitochondrial oxidative phosphorylation process through the binding of the toxic metabolite of methanol—formic acid—with the key enzyme of this process—cytochrome c oxidase. However, other mechanisms, including damage to the eye tissues by oxidative stress causing the intensification of the oxidative peroxidation process with the formation of cytotoxic compounds, as well as an increase in the synthesis of pro-inflammatory cytokines and influence on the expression of key proteins responsible for maintaining cell homeostasis, also play an important role in the pathogenesis of Me-ION. Histopathological changes in the eye tissues are mainly manifested as the degeneration of axons and glial cells of the optic nerve, often with accompanying damage of the retina that may involve all its layers. Despite the development of therapeutic approaches, persistent visual sequelae are seen in 30–40% of survivors. Thus, Me-ION continues to be an important problem for healthcare systems worldwide.

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Methanol poisoning in Turkey: Two outbreaks, a single center experience

Cited by 15 publications

References 29 publications

Methanol poisoning in the emergency department: a retrospective study

Methanol poisoning in the emergency department: a retrospective study

Delta values as a prognostic marker in methanol poisoning: a retrospective cohort study

Methanol-induced optic neuropathy: a still-present problem

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