İspirto zehirlenmesi olan iki olgunun başarılı yönetimi: olgu sunumu

Metanol zehirlenmesi, düşük doz alımda dahi morbidite ve mortaliteye yol açan alımı genellikle erişkinlerde kaza ya da intihar amaçlı, çocuklarda ise bilinçsiz bir şekilde alınması ile olabilen klinik durumdur. Özellikle erişkin dönemde ve erkeklerde çok görülen metanol zehirlenmesi çocuklarda nadir olarak bildirilmektedir. Bu yazımızda ispirto alımı sonrasında 30 dakika içinde hastanemiz acil polikliniğine getirilen 5 ve 7 yaşında iki erkek kardeş olgumuzun hızlı tanı ve tedavi ile başarılı tedavi yönetimini sunduk.

Methanol poisoning , which may lead to morbidity and mortality even at low dosage intake, which is usually suicide or accident purposeful in adults, with an unconscious manner in children is clinical condition. Especially in adulthood and men seen methanol poisoning it has been reported rarely in children. In this paper, we present successful treatment management with rapid diagnosis and treatment our hospital brought to the emergency department two brothers aged 5 and 7 cases within 30 minutes after intake of spirit.

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1. Barceloux GD, Bond GR, Krenzelok EP, Cooper H, Vale JA. American Academy of Clinical Toxicology Practice Guidelines on the Treatment of Methanol Poisoning. Clinical Toxicology 2002;40:415-46.

2. IPCS, Healthy and Safety Guide No. 105. Methanol; World Healthy Organization: Geneva,1997;105.

3. Takao H, Doi I, Watanabe T. Serial diffusion-weighted magnetic resonance imaging in methanol intoxication. J Comput Asist Tomogr 2006;30:742-4.

4. Onder F, Ilker S, Kansu T, Tatar T, Kural G. Acute blindness and putaminal necrosis in methanol intoxication. Int Ophthalmol 1999;22:8-14.

5. Victor M. Neurologic disorders due to alcoholism and malnutrition. In: Joynt RJ (ed). Clinical Neurology. 1st ed. Philadelphia, Lippincott Comp, 1992: 1-94.

6. Liesivuori J, Savolainen H. Methanol and formic acid toxicity: biochemical mechanisms. Pharmacol Toxicol 1991; 69: 157-63.

7. Jacobsen D, McMartin KE. Methanol and ethylene glycol poisonings. Mechanism of toxicity, clinical course, diagnosis and treatment. Med Toxicol 1986; 1: 309-34.

8. Berk WA, Henderson WV. Alcohols., In Tintinalli JE, Kelen GD, Stapczynski JS, editors, Emergency Medicine. A Comprehennsive Study Guide.5th ed. New York: McGraw Hill; 2000. p.1103-1109.

9. Keklikoğlu HD, Yoldaş TK, Çoruh Y. Metanol Zehirlenmesi ve Putaminal Hemoraji: Olgu Sunumu. Journal of Neurological Sciences [Turkish] 2007; 24: 338-42.

10. Abramson S, Singh AK. Treatment of the alcohol intoxications: ethylene glycol, methanol and isopropanol. Curr Opin Nephrol Hypertens 2000; 9: 695-701.

11. Blanco M, Casado R, Vazquez F, Pumar JM. CT and MR imaging findings in methanol intoxication. Am J Neuroradiol 2006;27:452-4.

12. Taheri MS, Moghaddam HH, Moharamzad Y, Dadgari S, Nahvi V. The value of brain CT findings in acute methanol toxicity. Eur J Radiol 2010;73:211-4.

13. Hassanian-Moghaddam H, Pajoumand A, Dadgar SM, Shadnia SH. Prognostic factors in metanol poisoning. Human Exp Toxicol 2007; 26: 583-6.

14. Halavaara J, Valanne L, Setala K. Neuroimaging supports the clinical diagnosis of methanol poisoning. Neuroradiology 2002;44:924-8.

15. Kurtoğlu S. Zehirlenmeler, Teşhis ve Tedavi. Kayseri, Erciyes Üniversitesi Yayınları, 1992: 209-32.

16. Bestic M, Blackford M, Reed M. Fomepizole: a critical assessment of current dosing recommendations. J Clin Pharmacol 2009; 49: 130-7.

17. Kraut JA, Kurtz I. Toxic alcohol ingestions: clinical features, diagnosis and management. Clin J Am Soc Nephrol 2008; 3: 208-25.

18. Wiener SW. Toxic Alcohols. In Flomenbaum NE, Goldfrank LR, HoffmanRS, Howland MA, Lewin NA, Nelson LS editor. Goldfrank's Toxicologic Emergencies. 8th ed. New York: McGraw Hill; 2006. p.1146-60.

19. Hantson P, Wallemacq P, Brau M, Vanbinst R, Haufroid V, Mahieu P. Two case of acute methanol poisoning partially treated by oral 4-methyl pryazole. Intensive Care Med 1999;25:528-31.

20. Megarbone B, Boron SW, Trout H, Hantson P, Jaeger A, 6. Krencker E et al. Treatment of acute methanol poisoning with fomepizole. Intensive Care Med 2001;27:1370-8.

21. Chow MT, Di Silvestro VA, Yung CY, Nawab ZM, Leehey DJ, Ing TS. Treatment of acute methanol intoxication with hemodialysis using an ethanol-enriched, bicarbonate-based dialysate. Am J Kidney Dis 1997; 30: 568-70.

22. Fraser AD. Methanol poisoning. CMAJ 1993; 149: 134-6.

23. Brent J, McMartin K, Phillips S, Aaron C, Kulig K, et al. Fomepizole for the treatment of methanol poisoning. N Engl J Med 2001; 344: 424-9.

24. Hovda KE, Hunderi OH, Tafjord AB, Dunlop O, Rudberg N, Jacobsen D. Methanol outbreak in Norway 2002-2004: epidemiology, clinical features and prognostic signs. J Intern Med 2005; 258: 181-90.