Outcomes following abuse of methanol-containing carburetor cleaners.
BACKGROUND
Carbureter cleaners may contain methanol and are abused via inhalation. Toxicity resulting from the methanol component of these products is poorly described.


METHODS
We conducted a retrospective poison center chart review over a four-year period (3/98-3/02) of outcomes following methanol-containing carbureter cleaners (MCC) exposure. Inclusion criteria were: (1) use of MCC, (2) evaluation in health care facility (HCF), (3) no known co-ingestion exposure and (4) at least 12 hour follow-up.


RESULTS
33 cases were reviewed with 11 cases excluded because of significant co-ingestions. Of the remaining 22 cases the mean age was 17 [range: 14-41] years old with 90% of cases between 14 and 17 years old. Six women and 16 men were in the study. Six of 22 cases had acidosis (serum bicarbonate < or =22 mmol/L or pH < or =7.35), 100% of patients had neurological symptoms (ataxia, etc.) and 14/22 had vomiting on presentation. Three patients received treatment with ethanol (1) and fomepizole (2). All others received intravenous fluids (15) or no treatment (4). Mean serum methanol concentration was 28mg/dl [range: 0-341 with 17/22 developing acidosis. Serum methanol was obtained at a mean of 3.5 hours [range 1-7 hours] post use. All metabolic disturbances resolved within 24 hours except in one patient (41 years old) in which her disturbances resolved within 72 hours. No patient developed visual disturbances or neurological sequealae.


CONCLUSIONS
Significant toxicity following inhalation of MCC was rare with symptoms improving without aggressive care (dialysis, alcohol dehydrogenase blockade).
LoVecchio
F
F
Banner Good Samaritan Regional Poison Center, Department of Medical Toxicology, Phoenix, AZ 85006, USA. Frank.LoVecchio@bannerhealth.com
Sawyers
B
B
Thole
D
D
Beuler
M C
MC
Winchell
J
J
Curry
S C
SC
D000138:Acidosis / Q000209:etiology / Q000473:pathology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000931:Antidotes / Q000627:therapeutic use; D000431:Ethanol / Q000627:therapeutic use; D005260:Female; D005440:Fluid Therapy; D000077604:Fomepizole; D006801:Humans; D019570:Inhalation Exposure; D007275:Injections, Intravenous; D008297:Male; D000432:Methanol / Q000097:blood / Q000506:poisoning*; D011041:Poisoning / Q000150:complications / Q000473:pathology* / Q000628:therapy; D011720:Pyrazoles / Q000627:therapeutic use; D012189:Retrospective Studies; D012997:Solvents / Q000032:analysis / Q000506:poisoning*; D019966:Substance-Related Disorders / Q000150:complications / Q000473:pathology*; D016896:Treatment Outcome
D000931:Antidotes; D011720:Pyrazoles; D012997:Solvents; D000431:Ethanol; D000077604:Fomepizole; D000432:Methanol