[Chance discovery of methanol poisoning during a state of inebriation].
We report a case of wood alcohol (methylated spirits) poisoning in a 40-year-old chronic alcoholic. The initial diagnosis of state of drunkenness was supported by the increased plasma level of ethanol (4.66 g.L-1) obtained with enzymatic method. The confirmation, using gas chromatography (GC), showed an unexpected peak with a retention time at 1.19 min, characteristic of methanol (0.41 g.L-1). The GC analysis of the absorbed beverage revealed a 5% methanol content. The osmolal gap was 115 mOsm.kg-1, with 13 mOsm.kg-1 due to methanol and 90 mOsm.kg-1 to ethanol. Seven hours after the ingestion, the anion gap was at 13 mmol-1. This result reflected the inhibition of methanol oxidation by alcohol-dehydrogenase, when the plasma ethanol concentration was above 1 g.L-1. This concentration was maintained by continuous intravenous administration of (Curéthyl-A) a 95% ethanol containing solution, until methanol concentration decreased below 0.2 g.L-1. The outcome was favourable without neurological and ophthalmological sequelae.
Ould-Ahmed
M
M
Département d'anesthésie, réanimation et urgences, hôpital d'instruction des armées Clermont-Tonnerre, Brest-Naval, France.
Drouillard
I
I
Fourel
D
D
Caroff
P
P
Guiavarch
M
M
D000136:Acid-Base Equilibrium; D000328:Adult; D000426:Alcohol Dehydrogenase / Q000037:antagonists & inhibitors; D000434:Alcoholic Beverages / Q000032:analysis*; D000435:Alcoholic Intoxication / Q000150:complications*; D002849:Chromatography, Gas; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D000431:Ethanol / Q000097:blood / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D000432:Methanol / Q000097:blood / Q000302:isolation & purification / Q000506:poisoning*; D009994:Osmolar Concentration; D010084:Oxidation-Reduction; D011041:Poisoning / Q000175:diagnosis / Q000188:drug therapy
D004791:Enzyme Inhibitors; D000431:Ethanol; D000426:Alcohol Dehydrogenase; D002955:Leucovorin; D000432:Methanol