Epidemic Acute Methanol Intoxication as a Result of Illicit Alcohol Ingestion

Background: Methanol poisoning, whether sporadic or mass poisoning, is an acute medical emergency. It can lead to considerable morbidity as well as mortality. Objectives: We retrospectively evaluated 30 cases of methanol intoxication admitted to the nephrology unit of our hospital. Materials and Methods: We collected demographic data, clinical findings, and laboratory parameters after the study protocol was approved by the local human ethics committee. Results: headache, dizziness, nausea, vomiting and visual disturbances were the most common complaints. Twenty-eight patients had high anion-gap metabolic acidosis. Five patients, without toxic optic neuropathy and serious metabolic acidosis, were treated with ethanol and bicarbonate infusions, and improved without requiring hemodialysis (hD). Twenty-five patients, who were admitted with visual disturbances or complete blindness or serious metabolic acidosis, were treated by hD; 7 of these patients (23.3%) died. All of them had blurred vision, were unconscious at presentation, and presented with metabolic acidosis with high anionic gap. No significant differences (P > 0.05) were found between patients with and without toxic optic neuropathy, in terms of biochemical parameters and blood gases. The 5 patients with toxic optic neuropathy were treated with oral methylprednisolone and hD. Two patients had complete remission, 2 others improved with total blindness, and 1 died. Conclusions: We found that unconsciousness and metabolic acidosis in cases of methanol intoxication were associated with an increased risk of mortality. Medical treatment and if necessary, hD, must be started as soon as possible, especially in the presence of mental state changes, visual disturbances, metabolic acidosis and a history of methanol ingestion.