Folinic acid and enhanced renal elimination in formic acid intoxication.
Ingestion of over 60 g of formic acid by an adult is potentially fatal. We report a case of a 36-year-old woman with a history of depression who ingested 110 g of formic acid. She survived a complicated intensive care hospitalization following usage of intravenous folinic acid, urinary alkalinization, intravenous furosemide and supportive care. We suggest a management protocol aimed at minimizing formate toxicity by enhancing hepatic formate degradation via the folinic acid 'one carbon pool' and by enhanced renal elimination of formate.
Moore
D F
DF
Poisons Unit, Guy's Hospital, London, United Kingdom.
Bentley
A M
AM
Dawling
S
S
Hoare
A M
AM
Henry
J A
JA
D000328:Adult; D005260:Female; D005561:Formates / Q000493:pharmacokinetics* / Q000506:poisoning* / Q000652:urine; D005665:Furosemide / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007262:Infusions, Intravenous; D007668:Kidney / Q000187:drug effects* / Q000378:metabolism*; D002955:Leucovorin / Q000627:therapeutic use*; D011041:Poisoning / Q000188:drug therapy / Q000652:urine; D013406:Suicide, Attempted
D005561:Formates; C030544:formic acid; D005665:Furosemide; D002955:Leucovorin