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Fomepizole as a therapeutic strategy in paediatric methanol poisoning. A case report and review of the literature

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Abstract

Methanol poisoning is not frequently observed in children; however, without treatment, serious intoxication can be complicated by visual impairment, coma, metabolic acidosis, respiratory and circulatory insufficiency and death. Treatment in a paediatric intensive care is therefore compulsory. Methanol is metabolised in the liver by alcohol dehydrogenase to the toxic metabolites formaldehyde and formic acid. Classically, ethanol is given as a competitive inhibitor in order to avoid the formation of these compounds. We report on the use of fomepizole (4-methylpyrazole),a new and potent inhibitor of alcohol dehydrogenase, in a 3-year-old boy after the intake of a toxic amount of methanol. The course was uneventful and the use of fomepizole was not accompanied by any side-effects. An overview is given of all cases of paediatric poisoning in which fomepizole was used. Conclusion:Fomepizole seems to be a safe and valid alternative to ethanol in cases of paediatric methanol poisoning.

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Abbreviations

ADH :

alcohol dehydrogenase

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Acknowledgements

We are grateful to P. Schepens and V. Coucke, Toxicology Centre, University of Antwerp, for the determination of methanol levels.

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Authors and Affiliations

  1. Department of Paediatrics, University Hospital of Antwerp, Antwerp, Belgium

    Nathalie De Brabander & Marek Wojciechowski

  2. Department of Intensive Care Medicine, University Hospital of Antwerp, Wilrijkstraat 10, 2650 , Edegem, Belgium

    Koen De Decker, Annick De Weerdt & Philippe G. Jorens

Authors
  1. Nathalie De Brabander
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  2. Marek Wojciechowski
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  3. Koen De Decker
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  4. Annick De Weerdt
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  5. Philippe G. Jorens
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Corresponding author

Correspondence to Philippe G. Jorens.

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De Brabander, N., Wojciechowski, M., De Decker, K. et al. Fomepizole as a therapeutic strategy in paediatric methanol poisoning. A case report and review of the literature. Eur J Pediatr 164, 158–161 (2005). https://doi.org/10.1007/s00431-004-1588-5

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  • DOI: https://doi.org/10.1007/s00431-004-1588-5

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