Osmolar gap with Minimal Acidosis in Combined Methanol and Methyl Ethyl Ketone Ingestion

Methyl ethyl ketone is a common solvent but data on overdose in humans are scarce. We report a case of co-ingestion of methyl ethyl ketone together with methanol associated with a hyperosmolar coma without anion gap metabolic acidosis. Blood levels of methyl ethyl ketone and its metabolite, 2-butano...

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Veröffentlicht in:Journal of toxicology. Clinical toxicology Jg. 32; H. 1; S. 79 - 84
Hauptverfasser: Price, E. A., D'alessandro, A., Kearney, T., Olson, K. R., Blanc, P. D.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Monticello, NY Taylor & Francis 01.01.1994
Dekker
Schlagworte:
Acidosis - chemically induced
Administration, Oral
Adult
Biological and medical sciences
Butanones - blood
Butanones - poisoning
Chemical and industrial products toxicology. Toxic occupational diseases
Drug Interactions
human
Humans
Male
Medical sciences
methanol
Methanol - blood
Methanol - poisoning
methyl ethyl ketone
Osmolar Concentration
poisoning
Poisoning - physiopathology
Solvents
Toxicology
Coma
Human
Nervous system diseases
Toxicity
Consciousness impairment
Acid base balance disorder
Ketone
Toxic association
Hyperosmolarity
Organic solvent
Metabolic disorder
Poisoning
Neurological disorder
Methanol
ISSN:0731-3810
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Zusammenfassung:Methyl ethyl ketone is a common solvent but data on overdose in humans are scarce. We report a case of co-ingestion of methyl ethyl ketone together with methanol associated with a hyperosmolar coma without anion gap metabolic acidosis. Blood levels of methyl ethyl ketone and its metabolite, 2-butanol, indicated that this solvent did contribute approximately 20 mosm/L to an observed osmolar gap of 99 mosm/L. At the levels detected, methyl ethyl ketone may have inhibited methanol metabolism, contributing to the low serum formate (1.3 mmol/L) and normal anion gap despite a blood methanol of 67 mmol/L.
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ISSN:0731-3810
DOI:10.3109/15563659409000434