Treatment of acute methanol poisoning with fomepizole ; Tratamiento con fomepizol de una intoxicación aguda por metanol

Methanol poisoning may cause metabolic acidosis, visual abnormalities and neurological dysfunction and may also result in severe sequelae or death. The treatment indicated is the administration of antidotes which inhibit the metabolization of the methanol by the alcohol dehydrogenase enzyme (ADH). Traditionally, ethyl alcohol has been used for this purpose, but recently, fomezipole, an inhibitor of alcohol dehydrogenase, has been introduced. We report on the first patient treated with this antidote in Spain. A 59-year-old man with a history of chronic alcoholism was admitted to the Emergency Department due to altered consciousness. Severe metabolic acidosis was detected and the patient admitted having consumed some 50 mL of rubbing alcohol. The serum methanol concentration was 0,24 g/l. Treatment was begun with sodium bicarbonate and fomepizole at a dose of 15 mg/kg, which was well-tolerated with no reappearance of acidosis. Reduced visual acuity and a small haemorrhage in the right optic papilla were observed, both of which were compatible with a toxic neuropathy.