Yoshizawa Tomohiro, Kamijo Yoshito, Fujita Yuji, Suzuki Yoshiki, Hanazawa Tomoki, Usui Kiyotaka, Kishino Tohru
Department of Pharmacy Saitama Medical University Hospital Iruma-gun Saitama Japan.
Emergency Medical Center & Poison Center Saitama Medical University Hospital Iruma-gun Saitama Japan.
Acute Med Surg. 2018 Apr 10;5(3):289-291. doi: 10.1002/ams2.339. eCollection 2018 Jul.
Is fomepizole necessary after massive ingestion of a mixture of methanol and ethanol? We report the case of a 37-year-old man who was transported to our Poison Center 12 h after ingesting 500 mL of fuel alcohol containing 70% methanol and 30% ethanol in a suicide attempt. On admission, he presented only with somnolence and mild metabolic acidosis. We hypothesized that most of the ethanol had been metabolized.
As the estimated serum concentration of methanol was lethal (242.6 mg/dL), fomepizole was given i.v. and hemodialysis was carried out twice, resulting in complete recovery. Later, the serum concentrations of both methanol and ethanol on admission were found to be 224.1 and 0.51 mg/dL, respectively.
Therapeutic intervention was delayed by half a day after ingestion of a product containing methanol and ethanol in the present case. If the patient had arrived earlier, he may have only been treated with hemodialysis, but not fomepizole.
大量摄入甲醇和乙醇混合物后是否需要使用甲吡唑？我们报告一例37岁男性病例，该患者在试图自杀时摄入了500毫升含70%甲醇和30%乙醇的燃料酒精，12小时后被送往我们的中毒控制中心。入院时，他仅表现为嗜睡和轻度代谢性酸中毒。我们推测大部分乙醇已被代谢。
由于估计的血清甲醇浓度具有致死性（242.6毫克/分升），给予静脉注射甲吡唑并进行了两次血液透析，患者完全康复。后来发现入院时血清甲醇和乙醇浓度分别为224.1和0.51毫克/分升。
在本病例中，摄入含甲醇和乙醇的产品后治疗干预延迟了半天。如果患者更早到达，他可能仅接受血液透析治疗，而无需使用甲吡唑。
