Delayed reversal of methanol-induced blindness in an adult by a combination of erythropoietin and a high dose of methylprednisolone: a case report.
Blindness
Erythropoietin
Methanol toxicity
Journal
Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382
Informations de publication
Date de publication:
20 Apr 2023
20 Apr 2023
Historique:
received:
27
02
2023
accepted:
09
03
2023
medline:
21
4
2023
pubmed:
20
4
2023
entrez:
19
04
2023
Statut:
epublish
Résumé
The clinical manifestation following methanol toxicity accounts for a life-threatening problem that contributes to metabolic disorders, neurological complications, blindness, and even death. There is no completely effective treatment to retain the patient's vision. Herein, we apply a new therapeutic strategy for the recovery of bilateral blindness in a patient who had ingested methanol. A 27-year-old Iranian man with complete bilateral blindness was referred 3 days after accidental ingestion of methanol to the poisoning center at Jalil Hospital, Yasuj, Iran, in 2022. After taking his medical history, performing neurologic and ophthalmologic examinations, and routine laboratory tests, ordinary management was undertaken and counterpoisons were given for 4-5 days; however, the blindness did not reverse. Following the 4-5 days of unsuccessful standard management, he was given ten doses of subcutaneous erythropoietin 10,000 IU/12 hours twice daily, folinic acid 50 mg/12 hours, and methylprednisolone 250 mg/6 hours for 5 days. After five days, vision of both eyes recovered, reaching 1/10 in the left and 7/10 in the right eye. He remained under daily supervision until his release from the hospital, and he was discharged from the hospital 15 days post admission. In outpatient follow-up, his visual acuity was improved without having any side effects at 2 weeks after discharge. A combination of erythropoietin and a high dose of methylprednisolone were useful for relieving the critical optic neuropathy and improved the optical neurological disorder following methanol toxicity.
Sections du résumé
BACKGROUND
BACKGROUND
The clinical manifestation following methanol toxicity accounts for a life-threatening problem that contributes to metabolic disorders, neurological complications, blindness, and even death. There is no completely effective treatment to retain the patient's vision. Herein, we apply a new therapeutic strategy for the recovery of bilateral blindness in a patient who had ingested methanol.
CASE PRESENTATION
METHODS
A 27-year-old Iranian man with complete bilateral blindness was referred 3 days after accidental ingestion of methanol to the poisoning center at Jalil Hospital, Yasuj, Iran, in 2022. After taking his medical history, performing neurologic and ophthalmologic examinations, and routine laboratory tests, ordinary management was undertaken and counterpoisons were given for 4-5 days; however, the blindness did not reverse. Following the 4-5 days of unsuccessful standard management, he was given ten doses of subcutaneous erythropoietin 10,000 IU/12 hours twice daily, folinic acid 50 mg/12 hours, and methylprednisolone 250 mg/6 hours for 5 days. After five days, vision of both eyes recovered, reaching 1/10 in the left and 7/10 in the right eye. He remained under daily supervision until his release from the hospital, and he was discharged from the hospital 15 days post admission. In outpatient follow-up, his visual acuity was improved without having any side effects at 2 weeks after discharge.
CONCLUSION
CONCLUSIONS
A combination of erythropoietin and a high dose of methylprednisolone were useful for relieving the critical optic neuropathy and improved the optical neurological disorder following methanol toxicity.
Identifiants
pubmed: 37076901
doi: 10.1186/s13256-023-03899-w
pii: 10.1186/s13256-023-03899-w
pmc: PMC10116800
doi:
Substances chimiques
Methanol
Y4S76JWI15
Methylprednisolone
X4W7ZR7023
Erythropoietin
11096-26-7
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
181Informations de copyright
© 2023. The Author(s).
Références
BMC Res Notes. 2013 Nov 20;6:479
pubmed: 24256873
BMJ Open. 2022 May 18;12(5):e056550
pubmed: 35584882
Indian J Ophthalmol. 2006 Mar;54(1):68-9
pubmed: 16531683
Hum Exp Toxicol. 2005 Feb;24(2):55-9
pubmed: 15850279
J Ophthalmic Vis Res. 2021 Apr 29;16(2):260-270
pubmed: 34055263
Indian J Ophthalmol. 2011 Mar-Apr;59(2):137-41
pubmed: 21350283
Am J Kidney Dis. 2016 Jul;68(1):161-7
pubmed: 27180631
Crit Care Med. 2015 Feb;43(2):461-72
pubmed: 25493973
Proc Natl Acad Sci U S A. 2000 Sep 12;97(19):10526-31
pubmed: 10984541
J Curr Ophthalmol. 2016 Mar 30;28(1):5-11
pubmed: 27239595
J Toxicol Clin Toxicol. 2001;39(6):627-31
pubmed: 11762672
Clin Nephrol. 2005 Sep;64(3):190-7
pubmed: 16175943
Arch Toxicol. 2022 Feb;96(2):431-451
pubmed: 34988610
Semin Dial. 2014 Jul-Aug;27(4):395-401
pubmed: 24712848
Lancet. 2018 Nov 10;392(10159):1923-1994
pubmed: 30496105
Int J Clin Pract. 2001 Nov;55(9):599-602
pubmed: 11770356
Int Ophthalmol. 2011 Dec;31(6):517-24
pubmed: 22200859
Emerg Med Int. 2013;2013:638057
pubmed: 23431453