Methanol intoxication: differential diagnosis from anion gap-increased acidosis

Motoki Fujita, Ryosuke Tsuruta, Jun Wakatsuki, Hitoshi Takeuchi, Yasutaka Oda, Yoshikatsu Kawamura, Susumu Yamashita, Shunji Kasaoka, Kiyoshi Okabayashi, Tsuyoshi Maekawa
Internal Medicine 2004, 43 (8): 750-4
We report a case of methanol intoxication, which was not distinguished from ethylene glycol intoxication during treatment. A 65-year-old man was transferred to our emergency department because of drowsiness and remarkable metabolic acidosis. He was intubated because his consciousness disturbance worsened. The diagnosis was suspected as methanol or ethylene glycol intoxication in addition to ethanol intoxication. Administration of ethanol and hemodialysis were chosen for his essential treatments. When he was extubated, he complained about visual loss. His brain computed tomography scans revealed putaminal lesions, which are rarely reported in methanol intoxication. Diagnosis of methanol intoxication was confirmed by the serum high methanol levels.

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