De Brabander Nathalie, Wojciechowski Marek, De Decker Koen, De Weerdt Annick, Jorens Philippe G
Department of Paediatrics, University Hospital of Antwerp, Antwerp, Belgium .
Eur J Pediatr. 2005 Mar;164(3):158-61. doi: 10.1007/s00431-004-1588-5. Epub 2004 Dec 1.
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.
Fomepizole seems to be a safe and valid alternative to ethanol in cases of paediatric methanol poisoning.
儿童甲醇中毒并不常见；然而，若不进行治疗，严重中毒可并发视力损害、昏迷、代谢性酸中毒、呼吸和循环功能不全以及死亡。因此，儿科重症监护治疗是必需的。甲醇在肝脏中由乙醇脱氢酶代谢为有毒代谢产物甲醛和甲酸。传统上，给予乙醇作为竞争性抑制剂以避免这些化合物的形成。我们报告了一名3岁男孩摄入有毒量甲醇后使用甲吡唑（4-甲基吡唑）的情况，甲吡唑是一种新型强效乙醇脱氢酶抑制剂。病程平稳，使用甲吡唑未出现任何副作用。文中概述了所有使用甲吡唑的儿科中毒病例。
在儿科甲醇中毒病例中，甲吡唑似乎是乙醇的一种安全有效的替代药物。
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