INTOXICATION BY METHANOL AND ETHYLENEGLYC OL - STUDY OF 18 PATIENTS

BACKGROUND: The present study reviews acute intoxication by methanol a nd ethylenglycol analyzing its form of presentation, treatment applied and prognosis. METHODS: A retrospective study performed in 5 hospital s from the Barcelona area (Spain) from January 1984 to December 1993 i s reported. RESULTS: Eighteen patients, 16 intoxicated by methanol and 2 by ethylenglycol were reviewed. The blood levels of methanol on adm ission ranged from 350 to 4,600 mg/l (mean = 1,649 +/- 1,220 mg/l). Th e clinical course was initially characterized by alteration of the lev el of consciousness (in 61% the index of Glasgow of coma was less than or equal to 7) and development of metabolic acidosis (pH less than or equal to 6.80 in 44% of cases). Eighty-seven percent of patients into xicated by methanol had visual disorders. Treatment consisted in the a dministration of ethanol, bicarbonate and extrarenal exchange. Mortali ty was 44%, being greater among patients with the lowest initial pH (p = 0.0001) and with the lowest concentration of bicarbonates (p < 0.03 ). The patients with lower pH (r(2) = 0.65, p < 0.002) and with a lowe r value of blood bicarbonate (r(2) = 0.87; p < 0.0001) on admission we re significantly more severe. Sequelae are present in 55% of the survi vors. CONCLUSIONS: Intoxication by methanol and ethylenglycol cause se vere metabolic acidosis, with high anion and osmolar gaps which may ra pidly lead to death or to sequelae in survivors if diagnosis is delaye d and specific treatment is not initiated early.