"Bita Dadpour, Ahmad Bagheri-Moghaddam, Vahid Reza Dabbagh-Kakhk, Mohammad Zaman Sheikh Arabi, Amir Habibi-Tamijani"
"A 42 year old man with heavy drinking of homemade alcohol was referred to our hospital due to acute chest pain. At the onset of admission, he developed a cardio respiratory arrest and CPR was started immediately. Heart rate and respiratory rate returned to normal range after 5 minutes of CPR; however LBBB was detected in ECG. He underwent emergency coronary angiography and normal coronary arteries were reported. After CPR, he was unconscious. Vital signs on admission in emergency department of clinical toxicology were: BP: 100/60, PR: 112/min, and RR: 24/min. He was intubated and underwent mechanical ventilation. Pupils were mydriatic and nonreactive to light. Physical examination revealed no pathologic sign in lungs, heart and abdominal organs. Gasometry on admission revealed: pH: 7.13, p CO2: 26.8, and HCO3: 9. Serum methanol level was: 61 mg/dl. 300 ml of Ethanol 20% as loading dose and then 30 cc per hour was initiated via gavage, folic acid was prescribed; haemodialysis was performed due to loss of consciousness, high methanol serum level and severe metabolic acidosis. Serum Urea and Cr were: 43 and 2.5 mg/dl respectively on admission and increased to 72 and 3.1 mg/dl respectively on second day after admission. He underwent two other sessions of hemodialysis. Brain MRI was carried out and bilateral ischemic hemorrhagic lesions in basal ganglia were reported. He was a case of methanol and ethanol toxicity who developed acute chest pain, loss of consciousness, bilateral hemorrhagic necrosis of Basal ganglia, acute tubular necrosis and finally blindness as a consequence of optic neuritis following methanol toxicity."
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