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Gastrointestinal and urinary tract bleeding in methanol toxicity
Babak Mostafazadeh1, Haleh Talaie, Arezou Mahdavinejad
1Shahid Beheshti University of Medical Sciences, Forensic Medicine and Clinical Toxicology, Loghman-Hakim Hospital Poison Center, Tehran 13334, Islamic Republic of Iran. mstzbmd@sbmu.ac.ir
BMJ Case Reports
|July 1, 2011
Summary
Methanol poisoning can cause serious bleeding complications, even after treatment with haemodialysis. This case highlights potential gastrointestinal bleeding risks associated with heparinization during dialysis for toxic metabolite removal.
Area of Science:
- Toxicology
- Nephrology
- Gastroenterology
Background:
- Methanol intoxication is a significant public health issue, particularly in developing regions.
- Haemodialysis is a critical intervention for severe methanol toxicity, aiding in the removal of toxic metabolites.
- Chronic alcohol abuse is a common comorbidity in methanol poisoning cases.
Observation:
- A 37-year-old male with a history of chronic alcohol abuse presented with methanol poisoning.
- Following haemodialysis for methanol toxicity, the patient developed haematuria and upper gastrointestinal bleeding.
- Upper endoscopy revealed only low-grade oesophageal ulceration.
Findings:
- The patient's haematuria and upper GI bleeding occurred post-haemodialysis.
- Heparinization, administered during haemodialysis, is a potential contributing factor to the observed bleeding.
- The endoscopic findings were not fully explained by the severity of the oesophageal ulceration alone.
Implications:
- This case suggests a potential link between heparinization during haemodialysis and gastrointestinal bleeding in methanol-intoxicated patients.
- Further investigation is warranted to understand the specific risks of anticoagulation in this clinical context.
- Clinical management of methanol poisoning should consider the potential for bleeding complications related to dialysis procedures.
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