ISSN: 0022-1198
CODEN: JFSCA
Page Count: 6

Definitive Identification of an Exceptionally High Methanol Concentration in an Intoxication of a Surviving Infant: Methanol Metabolism by First-Order Elimination Kinetics
Wu, AHB
Director, Supervisor, and Assistant Supervisor, Toxicology Laboratory,

McKay, C
Chief, Section of Medical Toxicology, Hartford Hospital, CT

Hill, D
Director, Microchemistry Laboratory, University of Connecticut, CT

Ostheimer, D
Director, Supervisor, and Assistant Supervisor, Toxicology Laboratory,

Forte, E
Director, Supervisor, and Assistant Supervisor, Toxicology Laboratory,

Kelly, T
Director, Inpatient Services, Department of Pediatrics,

(Received 24 May 1994; accepted 6 July 1994)

Abstract

Intoxication by methanol was identified in a five-week-old infant suffering from moderate metabolic acidosis. The initial serum methanol at admission was 1148 mg/dL as measured by gas chromatography. The osmolal gap and formic acid concentrations were consistent with methanol intoxication. The child was treated with folic acid and a continuous ethanol infusion and survived without any apparent permanent problems. Because expected toxic symptoms did not develop in this case, and the methanol concentrations were at levels that might be deemed to be incompatible with life, blood and urine samples were assayed by a specific enzymatic assay, and by gas chromatography/mass spectrometry (GC/MS). Positive results definitively confirmed the presence of methanol. In contrast to previous reports, the elimination of methanol in this case appeared to following first-order kinetics. If hepatic ADH activity is low in neonates and young infants, another enzyme system such as catalase may be involved to explain this data. The lack of formic acid accumulation may have been due to folic acid therapy.

Keywords:
toxicology, methanol intoxication, formic acid, alcohol dehydrogenase, catalase, first-order kinetics, gas chromatography/mass spectrometry

Paper ID: JFS15366J
DOI: 10.1520/JFS15366J
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