J Korean Soc Clin Toxicol.  2012 Jun;10(1):15-21.

Clinical Review of Toxic Alcohol Poisoning Cases in Korea

Affiliations
  • 1Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea. emstar@yuhs.ac
  • 2Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Korea.
  • 3Department of Emergency Medicine, College of Medicine, Konyang University, Daejeon, Korea.
  • 4Department of Emergency Medicine, National Health Insurance Corporation Ilsan Hospital, Gyeonggi-do, Korea.
  • 5Department of Emergency Medicine, College of Medicine, Soonchunhyang University, Korea.
  • 6Department of Emergency Medicine, Inje University Haeundae Paik Hospital, Busan, Korea.
  • 7Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Korea.

Abstract

PURPOSE
Toxic alcohols are responsible for accidental and suicide motivated poisonings, resulting in death or permanent sequelae for the afflicted patients. Major therapeutic modalities in these cases include treatment with alcohol dehydrogenase inhibitors and extracorporeal elimination. There have been a number of case reports of toxic alcohol intoxication in Korea. The purpose
of this study was to review the clinical characteristics of patients suffering toxic alcohol intoxication.
METHODS
We retrospectively reviewed the medical records of patients who presented with toxic alcohol intoxication at 8 emergency departments (ED) from Jun 2005 to Nov 2011. Patients who ingested methanol, isopropyl alcohol, ethylene glycol, and other alcohols except ethanol, were included in this study. The clinical characteristics of these patients were analyzed to include anion and osmolar gap, and estimated concentration of alcohol in the body.
RESULTS
During the study period, 21 patients were identified who had ingested toxic alcohol (methanol; 12 patients, ethylene glycol; 9 patients). At ED arrival, the mean anion gap was 18.7+/-6.9 and the osmolar gap was elevated in 13 patients. Oral and IV ethanol were administrated to 11 patients in order to inhibit alcohol dehydrogenase. Extracorporeal elimination procedures such as hemodialysis were performed in 9 patients. There were no fatalities, but the one patient suffered permanent blindness.
CONCLUSION
This study found that ethylene glycol and methanol were the substances ingested which produced toxic alcohol intoxication. The patients presented with high anion gap metabolic acidosis and were typically treated with oral ethanol and hemodialysis.

Keyword

Poisoning; Methanol; Ethylene glycol; Toxic alcohol
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