Transverse myelitis-like presentation of methanol intoxication: A case report and review of the literature

Algahtani, Hussein; Shirah, Bader; Ahmad, Raafat; Abobaker, Hind; Hmoud, Mohammed

doi:10.1080/10790268.2016.1226005

Cited by 7 publications

(5 citation statements)

References 8 publications

(8 reference statements)

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“…Methanol is well absorbed in the gastrointestinal tract, with peak levels reached within 30-90 minutes, and a serum half-life ranging from 14-20 hours (Brent et al, 2001). The volume of methanol distribution is 0.6-0.7 liters per kg, and it is primarily eliminated through liver metabolism, with only 2-5% excreted through the kidneys (Algahtani et al, 2018). Toxicity arises from the formation of formaldehyde and formic acid through liver alcohol dehydrogenase (Pereska et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…In the second re-treatment, the patient presented to the emergency room with a loss of consciousness accompanied by respiratory arrest. Respiratory arrest often serves as a terminal symptom occurring 6-36 hours after intoxication (Algahtani et al, 2018), indicating the possibility of the patient having an intoxication duration of ≥6 hours. Cardiopulmonary resuscitation (CPR) was performed following the American Heart Association Guideline (Drennan et al, 2020) In this condition, gastric lavage was not performed as the initial focus was on respiratory resuscitation.…”

Section: Discussionmentioning

confidence: 99%

“…Methanol poisoning in developing countries poses a severe health problem. Methanol, also known as methyl alcohol or CH3OH, is a clear, colorless, and volatile liquid widely used in commercial and industrial settings, as well as in products such as paint removers, varnishes, some brands of cologne and perfume, and even contaminated whiskey (Algahtani et al, 2018). The amount of methanol that can lead to toxicity ranges from 15-500 ml of a 40% solution to 60% pure methanol.…”

Section: Introductionmentioning

confidence: 99%

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Differences in Methanol Intoxication Patient Outcomes in First Admission and Re-admission: A Case Report

Ramdani,

Endah Tri Wulandari,

Sobran Jamil

et al. 2023

Indones. J. Nurs. Sci.

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"Oplosan Liquor" is an Indonesian term that refers to illegally made alcoholic beverages created by mixing ethanol or alcohol with other ingredients. The ethanol content in these beverages is uncontrolled and can pose a significant threat to human health. Consuming oplosan liquor with high levels of ethanol can cause alcohol poisoning and, in extreme cases, death. Methanol intoxication can impact patient outcomes, influencing factors such as appropriate treatment, adequate medical and psychological support, and the patient’s ability to avoid future methanol exposure. Differences in outcomes exist between patients mitted for the first time and those experiencing readmission. This case report aims to elucidate the unique distinctions in patient outcomes between those admitted for the first time and those readmitted after methanol intoxication. Materials and Methods: This case report describes an instance that occurred in the same patient, detailing their medical history, clinical symptoms, diagnostic tests, and treatment provided during their stay in the emergency department. Variances in outcomes were observed between two patients, with one succumbing to the effects and the other managing to survive. We share our experience in treating a patient with methanol intoxication during their initial admission and subsequent readmission to a hospital in Indonesia. Indonesian people are acquainted with a drink called "Oplosan Liquor," which is fermented to achieve an alcohol content of up to 90%. This beverage is consumed by many young people who lack knowledge about the use of alcoholic beverages.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Differences in Methanol Intoxication Patient Outcomes in First Admission and Re-admission: A Case Report

Ramdani,

Endah Tri Wulandari,

Sobran Jamil

et al. 2023

Indones. J. Nurs. Sci.

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“…Studies of methanol mass poisoning in Estonia, Norway and Czechia have reported acute mortality of 18%-21%, whereas the rate of sequelae after survival ranged between 10% and 34%[ 13 ]. As the most serious complication, cerebral hemorrhage is relatively rare with reported prevalence of 7%-19%[ 14 - 16 ].…”

Section: Discussionmentioning

confidence: 99%

Acute methanol poisoning with bilateral diffuse cerebral hemorrhage: A case report

Li¹,

Zheng²,

Liu³

et al. 2022

WJCC

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BACKGROUND Acute methanol poisoning (AMP) is a systemic disease that mainly affects the central nervous system and is characterized by ocular damage and metabolic acidosis. If appropriate treatments are inadequate or delayed, the mortality can exceed 40%. As the most serious complication, cerebral hemorrhage is rare with reported prevalence of 7%-19%. CASE SUMMARY A 62-year-old man drank liquor mixed with 45% methanol and 35% alcohol. His vision blurred 10 h later and he fell into coma in another 9 h. Serum toxicological tests were performed immediately, and continuous renal replacement therapy (CRRT) was carried out as the lactic acid exceeded 15 mmol/L and blood pH was 6.78. In addition, the toxicological report revealed 1300.5 μg/mL of methanol in serum and 1500.2 μg/mL in urine. After 59 h of CRRT, the methanol level decreased to 126.0 μg/mL in serum and 151.0 μg/mL in urine. However, the patient was still unconscious and his pupillary light reflex was slow. Computed tomography showed hemorrhage in the left putamen. After 16 d of life support treatment, putamen hemorrhage developed into diffuse symmetric intracerebral hemorrhage. In the end, his family gave up and the patient was discharged, and died in a local hospital. CONCLUSION Cerebral hemorrhage requires constant vigilance during the full course of treatment for severe cases of AMP.

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“…A literature search of methanol toxicity cases in Saudi Arabia (SA) revealed only four cases ( Algahtani et al, 2018 ; Althwanay et al, 2020 ; Owolabi et al, 2020 ). However, Galvez-Ruiz et al described outcomes of optic disk cupping following methanol poisoning in a series of 50 cases presenting at two large hospitals in Riyadh between 2008 and 2014, possibly indicating a higher incidence of methanol toxicity than perceived ( Galvez-Ruiz et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Can’t find the antidote: A root cause analysis

2022

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Background: In a series of cases that came to be recognized as a national methanol outbreak, an incident of delay in allocation and treatment with the antidote fomepizole is described with aim of sharing a learning experience.Method: A team of 16 members was formed to conduct a Root Cause Analysis (RCA), which included multiple individual interviews with the stakeholders and inspection visits to the area.Results: Root causes: The restocking process was unclear and inconsistent and specifically lacked a restocking policy for antidotes, inappropriate labeling and area design, and a sound-alike between fomepizole and omeprazole. Contributing factors included: unsuitable restocking practice and lack of training in using the pharmaceutical electronic inventory system. Corrective actions were recommended and implemented.Conclusion: Management of antidotes in large healthcare systems requires a team effort to ensure appropriate and timely availability in emergency poisoning cases. This RCA identified important areas for improvement that could be insightful to other institutions in preventing similar vulnerabilities and is unique in describing the details of system improvements that can have a large impact on patient safety.

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Transverse myelitis-like presentation of methanol intoxication: A case report and review of the literature

Abstract: We recommend performing MRI of the cervicothoracic spine in every methanol intoxication case to exclude both asymptomatic and symptomatic cases of spinal cord involvement.

Cited by 7 publications

References 8 publications

Differences in Methanol Intoxication Patient Outcomes in First Admission and Re-admission: A Case Report

Differences in Methanol Intoxication Patient Outcomes in First Admission and Re-admission: A Case Report

Acute methanol poisoning with bilateral diffuse cerebral hemorrhage: A case report

Can’t find the antidote: A root cause analysis

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