Fatal methanol poisoning with different clinical and autopsy findings: Case report and literature review

尸检 甲醇中毒 医学 法医病理学 医疗急救 毒物控制 职业安全与健康 急诊医学 病理 甲醇 化学 有机化学
作者
Meihui Tian,Hongyu He,Ye Liu,Rubo Li,Bao-Li Zhu,Zhipeng Cao
出处
期刊:Legal Medicine [Elsevier]
卷期号:54: 101995-101995 被引量:15
标识
DOI:10.1016/j.legalmed.2021.101995
摘要

Methanol poisoning is responsible for high morbidity and mortality, and the elevated concentration of methanol in the body is the major criteria for forensic diagnosis of methanol poisoning. However, in cases with lower methanol concentrations, diagnosis is mainly dependent on highly variable postmortem manifestations. Herein, we report a fatal methanol poisoning cases that two subjects ingested the same amount of methanol simultaneously, yet the subject one presented only non-specific gastrointestinal and mild central nervous system symptoms, while the other subject exhibited typical toxic manifestations with the exception of visual compromise. In autopsy, subject number 1 did not show typical pathological changes caused by methanol poisoning, except for the elevated levels of methanol in body fluids. On the contrary, bilateral basal ganglia hemorrhage and necrosis caused by methanol-induced brain lesion was observed in case number 2. Due to the complex and multifactorial process of methanol intoxication, many factors, including comprehensive autopsy, quantitative detection of methanol and formic acid, and genotype analysis, participate in its metabolism and toxicity, and can impact the clinical symptoms, prognosis and postmortem manifestations. Therefore, a combination of multiple diagnosis methods may more accurately contribute to the forensic diagnosis of methanol poisoning and should be tailored on an individual basis. This case report also reviews forensic diagnosis literature on methanol poisoning to provide a reference for forensic pathologists.
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