Manifestaciones clínicas y tratamiento de la intoxicación con Metanol

Dr. Adrián Goyenaga
Médico General
Investigador independiente
San José, Costa Rica.

Dra. Joyce Valverde
Médico General
Investigadora independiente
San José, Costa Rica.

Dra. Daniela Zamora
Médico General
Investigadora independiente
San José, Costa Rica.

Dr. Juan Carlos Solano
Médico General
Investigador independiente
San José, Costa Rica.

Dr. Roberto Sittenfeld
Médico General
Investigador independiente
San José, Costa Rica.

Resumen

La intoxicación por metanol representa un problema de salud tanto en países en vías de desarrollo como en países desarrollados. Es importante destacar que la toxicidad del metanol proviene en su mayor parte de sus metabolitos tóxicos: ácido fórmico, formaldehído y formiato. La presentación clínica involucra diversas alteraciones sistémicas que son potencialmente mortales y que requieren un manejo temprano y multidisciplinario. Dentro de los sistemas más afectados se encuentran: SNC, las vías visuales, el equilibrio ácido base, el sistema cardiopulmonar y el sistema renal. Dichas alteraciones pueden resultar irreversibles con altas tasas de mortalidad y morbilidad. El diagnóstico se realiza mediante una alta sospecha clínica y el apoyo de estudios de laboratorio complementarios. El tratamiento se basa en medidas de soporte, uso de inhibidores de la deshidrogenasa alcohólica, terapia de sustitución renal y derivados de folatos. En esta revisión bibliográfica se toma en cuenta de manera integral y actualizada, la presentación clínica y el abordaje terapéutico de la intoxicación con metanol.

Palabras claves

Metanol, Fomepizole, acidosis, etanol, intoxicación, hemodiálisis.

Abstract

Methanol poisoning represents a health problem in both developing and developed countries. It is important to note that the toxicity of methanol comes mostly from its toxic metabolites: formic acid, formaldehyde, and formate. The clinical presentation involves various systemic alterations that are life-threatening and require early and multidisciplinary management. Among the most affected systems are: CNS, visual pathways, acid base balance, cardiopulmonary system and renal system. These alterations can be irreversible with high mortality and morbidity rates. The diagnosis is made based on a high clinical suspicion and the support of complementary laboratory studies. Treatment is based on support measures, use of alcohol dehydrogenase inhibitors, renal replacement therapy and folate derivatives. In this bibliographic review, the clinical presentation and the therapeutic approach of methanol intoxication are taken into account in a comprehensive and updated manner.

Keywords

Methanol, Fomepizole, acidosis, ethanol, intoxication, hemodialysis.

Bibliografía

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