Methanol Toxicity: An Emergency Department and Toxicologist Dilemma – Methanol Case Series, Investigation of Medical Professionals’ Knowledge, and Review of The Literature

Authors

  • Sahar Y. Issa
  • Maha K. Al Mazroua
  • Naglaa F Mahmoud

DOI:

https://doi.org/10.37506/ijfmt.v16i1.17902

Keywords:

Methanol poisoning, toxicity, hemodialysis, occupational exposure, coma.

Abstract

Methanol is a clear, colorless, highly toxic alcohol widely used as paint, varnish removers, automotive
radiators, and washer fluid. Methanol intoxication incidence can be due to accidental, occupational,
suicidal exposure or following an adulterated liquor’s ingestion. Methanol is not toxic itself but will be
metabolized to the exceedingly poisonous formaldehyde and formic acid. Methanol ingestion ends in
wide anion-gap metabolic acidosis and devastating neurological complications, including drowsiness
to coma and devastating intracranial hemorrhages. Severe toxicities can occur with an intake of 0.25
ml/kg of 100% methanol. The blood level of methanol above 25 mg/dl is considered highly toxic.
Methanol reaches its peak plasma levels within an hour. Treatment guidelines include antidotal therapy,
hemodialysis, and metabolic acidosis correction. Due to methanol’s poisoning severity and grave
outcome of the affected cases, we had to present 4 case series for methanol intoxication, each with its
clinical manifestations and laboratory findings, to enlighten the medical practitioners about possible
causes, presentations, and treatment modalities of such severe toxicity.
Four methanol poisoning case series with different presentations were discussed in the current work.
A questionnaire about methanol poisoning awareness was distributed through the ER physicians’ and
nurses’ mail to investigate their ability to diagnose and treat methanol poisoning cases.
More training of ER medical staff on toxicological presentations is highly recommended. Clinical and
analytical toxicologists should have a more prominent role in the management of such cases. More
light and international publicity should be shed upon the methanol toxicity outbreaks encountered
globally, with frequently updating the diagnostic and therapeutic guidelines following an evidencebased
approach are highly recommended.

Author Biographies

  • Sahar Y. Issa

    Associate Professor, Department of Forensic Medicine and Clinical Toxicology. Faculty of Medicine, Alexandria University-Egypt 

  • Maha K. Al Mazroua

    Regional Poison Control Centre, Dammam-KSA

  • Naglaa F Mahmoud
    Regional Poison Control Centre, Dammam-KSA Professor, Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Cairo University-Egypt 

Downloads

Published

2022-03-25

How to Cite

Methanol Toxicity: An Emergency Department and Toxicologist Dilemma – Methanol Case Series, Investigation of Medical Professionals’ Knowledge, and Review of The Literature. (2022). Indian Journal of Forensic Medicine & Toxicology, 16(1), 1743-1758. https://doi.org/10.37506/ijfmt.v16i1.17902