Acute methanol intoxications registered in Varna region (Bulgaria) for a 25-year period

Petko Marinov; Kaloyan Georgiev; Yulichka Subeva; Dobri Ivanov; Snezha Zlateva; Ivaylo Vazharov

doi:10.14748/ssp.v4i2.4338

Acute methanol intoxications registered in Varna region (Bulgaria) for a 25-year period

Petko Marinov, Kaloyan Georgiev, Yulichka Subeva, Dobri Ivanov, Snezha Zlateva, Ivaylo Vazharov

Abstract

This retrospective study was conducted to follow out acute intoxications with methanol in Varna region (Bulgaria) for a 25-year period (1991-2015). At that time, 98 patients with methanol poisoning were regis- tered in the Clinic of Toxicology of Military Medical Academy in Varna, Bulgaria. The average age of the patients was 44.5 years. The diagnosis was made based on symptoms and was confirmed by gas chromato- graphic analysis of methanol concentration. The majority of poisonings were accidental - 88.9 %, and only a small part was with suicidal intentions (9.2%). Lethal outcome was registered in 38 patients. Eight of the survived patients (13.3%) were with residual visual impairment and six of them had permanent neurologi- cal complications.

Keywords

acute poisoning; intoxication; methanol; coma; convulsions

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References

Kim HJ, Na JY, Lee YJ, Park JT, Kim HS. An autop- sy case of methanol induced intracranial hemor- rhage. Int J Clin Exp Pathol. 2015; 8(10):13643-6.

McMartin K, Jakobsen D, Hovda KE. Antidotes for poisoning by alcohols that form toxic metabo 16 Scripta Scientifica Pharmaceutica, 2017;4(2):14-18

Medical University of Varnalites. Br J Clin Pharmacol. 2016;81(3):505-15. doi: 10.1111/bcp.12824.

Barbera N, Indorato F, Spitareli A, Bosco A, Car- pinteri M, Busardo FP, et al. A singular case of survival after acute methanol poisoning: toxico- logical and neurological findings. Am J Foren- sic Med Pathol. 2014;35(4):253-5. doi: 10.1097/ PAF.0000000000000127.

Nand L, Chander S, Kashyap R, Gupta D, Jhobta A. Methyl alcohol poisoning: a manifestation of typi- cal toxicity and outcome. J Assoc Physicians India. 2014;62(8):756-9.

Rietjens SJ, de Lange DW, Meulenbelt J. Ethylene glycol or methanol intoxication: which antidote should be used, fomepizole or ethanol? Neth J Med. 2014; 72(2):73-9.

Shadnia S, Rahimi M, Soltaninejad K, Nilli A. Role of clinical and paraclinical manifestations of meth- anol poisoning in outcome prediction. J Res Med Sci. 2013;18(10):865-9.

Paasma R, Hovda KE, Tikkerberi A, Jacobsen D. Methanol mass poisoning in Estonia: outbreak in 154 patients. Clin Toxicol (Phila). 2007; 45(2):152-7. doi: 10.1080/15563650600956329.

Zakharov S, Pelclova D, Urban P, Navratil T, Dib- lik P, Kuthan P, et al. Czech mass methanol out- break 2012: epidemiology, challenges and clinical features. Clin Toxicol (Phila). 2014; 52(10):1013-24. doi: 10.3109/15563650.2014.974106.

Desai T, Sudhalkar A, Vyas U, Khamar B. Meth- anol poisoning: predictors of visual outcomes. JAMA Ophthalmol. 2013;131(5):698

Kalkan S, Cevik A, Cavdar C, Aygoren O, Ak- gun A, Ergun N, et al. Acute methanol poison- ing reported to the Drug and Poison Information Center in Izmir, Turkey. Vet Hum Toxicol. 2003; 45(3):334-7.

Rogaczewska A, Kobza-Sindlewska K, Krakowi- ak A, Piekarska-Wijatkowska A. Acute alcohol poi- soning among patients in Toxicology Unit, Nofer Insitute of Occupational Medicine in the period of time 2007-2012. Przegl Lek. 2014; 71(9):479-83.

Thanacoody RH, Gilfillan C, Bradberry SM, Da- vies J, Jackson G, Vale AJ, et al. Management

of poisoning with ethylene glycol and meth- anol in the UK: a prospective study conduct- ed by the National Poisons Information Service

(NPIS). ClinToxicol (Phila). 2016;54(2):134-40. doi: 10.3109/15563650.2015.1116044.

Celik S, Karapirli M, Kandemir E, Ucar F, Kant- arci MN, Gurler M, et al. Fatal ethyl and methyl al- cohol-related poisoning in Ankara: A retrospec- tive analysis of 10720 cases between 2001 and 2011. J Forensic Leg Med. 2013; 20(3):151-4. doi: 10.1016/j. jflm.2012.05.009.

Coulter CV, Farquhar SE, McSherry CM, Isbis- ter GK, Duffull SB. Methanol and ethylene gly- col acute poisoning - predictors of mortali-

ty. Clin Toxicol (Phila). 2011; 49(10): 900-6. doi: 10.3109/15563650.2011.630320.

Giovanetti F. Methanol poisoning among trav- ellers to Indonesia. Travel Med Infect Dis. 2013; 11(3):190-3. doi: 10.1016/j.tmaid.2013.03.013.

Zakharov S, Kurcova I, Navratil T, Salek T, Kom- arc M, Pelclova D. Is the measurement of serum formate concentration useful in the diagnostics of acute methanol poisoning? A prospective study of 38 patients. Basic Clin Pharmacol Toxicol. 2015; 116(5): 455-51. doi: 10.1111/bcpt.12338.

Zakharov S, Kotikova K, Vaneckova M, Seidl Z, Nurieva O, Navratil T, et al. Acute methanol poi- soning: Prevalence and predisposing factors of haemorrhagic and non-haemorrhagic brain lesions. Basic Clin Pharmacol Toxicol. 2016;119(2):228-38. doi: 10.1111/bcpt.12559.

Sabeva Y, Marinov P, Zlateva S, Koleva M. Dena- turated alcohol as a frequent source of methanol intoxication. Journal of IMAB - Annual Proceed- ing (Scientific Papers). 2007; 13(1):98. doi: 10.5272/ jimab.2007131.98.

Rajamani A. Two cases of toxic methanol ingestion, one leading to brain death: case reports and brief review. Crit Care Resusc. 2012; 14(1):56-9.

Kraut JA. Diagnosis of toxic alcohols: lim- itations of present methods. Clin Tox-

icol (Phila). 2015;53(7):589-95. doi: 10.3109/15563650.2015.1056880.

Paasma R, Hovda KE, Hassanian-Moghaddam H, Brahmi N, Afshari R, et al. Risk factors to poor outcome after methanol poisoning and the rela- tion between outcome and antidotes-a multicentre study. Clin Toxicol (Phila). 2012; 50(9):823-31.

Marraffa J, Cohen V, Howland M. Antidotes for Toxicological Emergencies. Am J Health Syst Pharm. 2012;69(3):199-212. doi: 10.2146/ajhp110014.

Zakharov S, Pelclova D, Navratil T, Belacek J, Kom- arc M, et al. Fomepizole versus ethanol in the treat- ment of acute methanol poisoning: Comparison

DOI: http://dx.doi.org/10.14748/ssp.v4i2.4338