Fomepizole as a therapeutic strategy in paediatric methanol poisoning. A case report and review of the literature.
Methanol poisoning is not frequently observed in children; however, without treatment, serious intoxication can be complicated by visual impairment, coma, metabolic acidosis, respiratory and circulatory insufficiency and death. Treatment in a paediatric intensive care is therefore compulsory. Methanol is metabolised in the liver by alcohol dehydrogenase to the toxic metabolites formaldehyde and formic acid. Classically, ethanol is given as a competitive inhibitor in order to avoid the formation of these compounds. We report on the use of fomepizole (4-methylpyrazole),a new and potent inhibitor of alcohol dehydrogenase, in a 3-year-old boy after the intake of a toxic amount of methanol. The course was uneventful and the use of fomepizole was not accompanied by any side-effects. An overview is given of all cases of paediatric poisoning in which fomepizole was used.


CONCLUSIONS
Fomepizole seems to be a safe and valid alternative to ethanol in cases of paediatric methanol poisoning.
De Brabander
Nathalie
N
Department of Paediatrics, University Hospital of Antwerp, Antwerp, Belgium .
Wojciechowski
Marek
M
De Decker
Koen
K
De Weerdt
Annick
A
Jorens
Philippe G
PG
D000931:Antidotes / Q000627:therapeutic use*; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D000077604:Fomepizole; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D000432:Methanol / Q000506:poisoning*; D011041:Poisoning / Q000188:drug therapy; D011720:Pyrazoles / Q000627:therapeutic use*; D012997:Solvents / Q000506:poisoning*
D000931:Antidotes; D011720:Pyrazoles; D012997:Solvents; D000077604:Fomepizole; D002955:Leucovorin; D000432:Methanol