2018 Volume 9 Issue 1 Pages 32-35
A man in his fourth decade who had ingested 95mL of methanol 24 hours prior to admission was transferred to our hospital complaining of a headache. On admission, his vital signs were stable. Blood gas analysis revealed a pH of 7.229 and an anion gap (AG) of 23.7mEq/L. Despite the administration of folic acid and fluid replacement therapies, the AG elevated to 29.0mEq/L, and hemodialysis was performed for 3 hours. At the end of hemodialysis, the osmolality gap (OG) decreased from 62.7mOsm/kg to 33.2mOsm/kg, and the AG decreased to 15.6mEq/L. The OG fell to 26.9mOsm/kg 5.5 hours following the end of hemodialysis, but the AG elevated to 16.1mEq/L, and 3-hour hemodialysis was performed again, resulting in a decrease of the AG to 9.1mEq/L. He was discharged from the hospital without any sequelae. The measurement of methanol and formic acid is not available at most clinical laboratories. Our results demonstrate that monitoring of OG and AG resulting from respective increased methanol and formic acid are useful in the treatment of methanol intoxication.
