Clinical and metabolic features of ethanol-methanol poisoning in chronic alcoholics

The kinetics of methanol were examined in 84 chronic alcoholics admitted after drinking a cleansing solution containing 90% ethanol and 5% methanol. On admission, the average blood methanol concentration was 20 mmol/l (64 mg/dl) and blood ethanol concentration was 39 mmol/l (179 mg/dl). Although these patients were not treated with ethanol, and methanol concentrations remained high as blood ethanol concentrations fell to zero, no acidosis or other signs of classic methanol poisoning developed. The rate of metabolism of methanol was correlated to the initial ethanol concentration. To avoid unnecessary invasive therapy, treatment of methanol poisoning should be based on the case history, clinical signs, and laboratory features-not solely on blood methanol concentrations.