title: Refractory status epilepticus, serious rhabdomyolysis, acute liver injury, and pancytopenia after a massive intake of ethyl methanesulfonate: a case report.
abstract: Ethyl methanesulfonate is a mutagenic, alkylating agent and considered harmful to humans at levels greater than a certain threshold; however, the toxicity at high doses remains unclear. We report a case of a Japanese man who presented with status epilepticus, rhabdomyolysis, pancytopenia, and hair loss after accidental ingestion of a massive amount of ethyl methanesulfonate. The patient completely recovered with critical care, including multiple antiepileptic drugs, renal replacement therapy, blood transfusion, granulocyte colony-stimulating factor therapy, and antibacterial/fungal prophylaxis. The case indicates that ethyl methanesulfonate causes neurotoxicity, hepatotoxicity, hematotoxicity, and renal toxicity, which can be successfully treated with appropriate palliative therapies.
authors.affiliation: Department of Hematology, Shizuoka Saiseikai General Hospital Shizuoka, Japan ; Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University Kyoto, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamazaki
authors.affiliation: Department of Pathology, Shizuoka Saiseikai General Hospital Shizuoka, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Tajima
authors.affiliation: Department of Hematology, Shizuoka Saiseikai General Hospital Shizuoka, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Takeuchi
keywords: Ethyl methanesulfonate; acute toxicity; pancytopenia; rhabdomyolysis; status epilepticus