Methanol poisoning outbreak in a northwestern Moroccan town: report of 22 cases treated with hemodialysis.

Introduction: Methanol poisoning, a serious healthcare problem in resource-poor countries, is usually caused by unintentional ingestion. Early diagnosis and optimal treatment are crucial to prevent morbidity and mortality.

Methods: We report our experience with hemodialysis in patients with methanol poisoning from consumption of adulterated alcoholic beverages.

Results: Of 202 patients admitted to provincial and regional hospitals with methanol poisoning, the overall mortality rate was 5%. A total of 22 patients underwent hemodialysis, none of whom died. Most were male (86.4%), with a median [IQR] age of 32 years [22-39 years]. Patients typically presented with inebriation, vomiting, blurred vision, and/or decreased visual acuity. The median [IQR] bicarbonate concentration was 10 mmol/L [8.3-19.6 mmol/L] and the median [IQR] arterial pH was 7.1 [6.9-7.13]. Methanol blood concentrations ranged from 40-1,830 mg/L before hemodialysis. Nineteen patients made a full recovery, but permanent blindness developed in three. Blood methanol concentrations were significantly higher in patients with permanent blindness (P = 0.02).

Discussion: The optimal treatment of patients with methanol poisoning requires early recognition and initiation of effective therapy. Fomepizole is a safe and preferred antidote but is costly and currently unavailable in Morocco. We opted for oral ethanol therapy in combination with hemodialysis. Oral ethanol was well tolerated, and no adverse effects were observed.

Conclusion: Despite the severity of the methanol poisoning cases received in our department, no fatalities were recorded. We believe that the implementation of a standardized clinical protocol issued by health authorities, timely initiation of hemodialysis, and the use of oral ethanol contributed to good patient outcomes.