Metanol Zehirlenmesi ve Yüksek D-Dimer Seviyeleri

Metanol, renk, koku ve kıvam açısından etil alkole çok benzer. Metanol intoksikasyonu genellikle etanolün metanol ile değiştirilmesiyle hazırlanan yasa dışı olarak üretilmiş sahte içeceklerin ağızdan alınmasından kaynaklanır. Karın ağrısı, bulantı ve kusma, baş ağrısı, görme bozuklukları, şiddetli metabolik asidoz, görme kaybı, kardiyovasküler instabilite ve ölüm metanol intoksikasyonunda gelişebilir. Şiddetli metabolik asidoz en önemli mortalite nedenidir. Ancak literatürde metanol intoksikasyonu sonucu olan bir D-dimer yüksekliği bildirilmemiştir. Metanol intoksikasyonuyla gelen bu vakada hem bulguları hatırlatılarak gelişen şiddetli metabolik asidoza dikkat çekilecek, hem de klinik ve laboratuar düzelmeye rağmen beklenmeyen D-dimer yüksekliği paylaşılacaktır.

Methanol Intoxication and High D-Dimer Levels

Methanol is very similar to ethyl alcohol in terms of color, odor and consistency. Methanol intoxication is generally caused by oral intake of illegally produced fake drinks prepared by replacing ethanol with methanol. Abdominal pain, nausea, and vomiting,visual disturbances, headache, severe metabolic acidosis, vision loss, cardiovascular instability and death may develop in methanol intoxication. Severe metabolic acidosis is the most important cause of mortality. But a D-dimer elevation is not reported primarily due to methanol intoxication in the literatüre. In this case, the severe metabolic acidosis that develops will be pointed out by reminding the findings of methanol intoxication and the unexpected and persistent D-dimer elevation despite the normal clinical and laboratory status will be shared.

___

  • 1. Anadolu Agency News. 29/12/2021.https://www.aa.com.tr/tr/ agenda /in Turkey
  • 2. Koca T, Hilal A. Methyl Alcohol (Methanol) Intoxication. Bulletin of Legal Medicine,2020; 25(2): 128-138
  • 3. Ott J, Gronemann V, Pontzen F, Fielder E, Grossman G, Burkhard Kersebohm D et al. Methanol. Ullmann's Encyclopedia of Industrial Chemistry doi:10.1002/14356007.a16_465.pub3
  • 4. Pohanka M. Toxicology and the biological role of methanol and ethanol: Current view. Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia. 2016;160(1):54-63. doi:10.5507/BP.2015.023
  • 5. Kruse JA. Methanol and ethylene glycol intoxication. Critical care clinics. 2012;28(4):661-711. doi:10.1016/J.CCC.2012.07.002
  • 6. Liesivuori J, Savolainen AH. Methanol and formic acid toxicity: biochemical mechanisms. Pharmacology & toxicology. 1991;69(3):157-163.doi:10.1111/J.1600-0773.1991.TB01290.X
  • 7. Paasma R, Hovda KE, Hassanian-Moghaddam H, et al. Risk factors related to poor outcome after methanol poisoning and the relation between outcome and antidotes – a multicenter study.2012;50(9):823-831. doi:10.3109/15563650.2012.728224
  • 8. McMahon DM, Winstead S, Weant KA. Toxic alcohol ingestions: Focus on ethylene glycol and methanol. Advanced Emergency Nursing Journal.2009;31(3):206-213. doi:10.1097/TME.0b013e3181ad8be8
  • 9. Taskın O, Açıkalın A, Disel N.R. Methyl Alcohol Intoxications. Anatolian Journal of Emergency Medicine 2022;5(1):37-42
  • 10. Chan-Seok Moon. Estimations of the lethal and exposure doses for representative methanol symptoms in humans. Moon Annals of Occupational and Environmental Medicine (2017) 29:44. doi: 10.1186/s40557-017-0197-5