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Formate levels following a formalin ingestion.
K K Burkhart1, K W Kulig, K E McMartin
1Rocky Mountain Poison and Drug Center, University of Colorado, Health Sciences Center, Denver 80204-4507.
Veterinary and Human Toxicology
|April 1, 1990
Summary
Formalin ingestion caused severe toxicity, with rising methanol, formaldehyde, and formate levels. Delayed absorption and organ failure occurred despite treatment, highlighting the critical danger of this poison.
Area of Science:
- Toxicology
- Clinical Chemistry
Background:
- Formalin (formaldehyde solution) ingestion is a rare but dangerous poisoning.
- Recent advancements allow for precise measurement of formaldehyde and formate in plasma.
Observation:
- A fatal case of formalin ingestion is detailed, tracking methanol, formaldehyde, and formate levels.
- The patient experienced CNS depression, abdominal pain, seizures, DIC, and cardiac arrest over 13 hours.
Findings:
- Methanol levels continuously increased post-ingestion.
- Formaldehyde and formate levels rose until bicarbonate and ethanol therapy were initiated.
- Delayed gastric absorption due to formaldehyde's "fixing" effect is hypothesized.
Implications:
- This case underscores the severe toxicity and potential lethality of formalin ingestion.
- Early and aggressive treatment, including fomepizole or ethanol, is crucial.
- Monitoring of toxic alcohol metabolites is vital for guiding therapy.