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Estimating Plasma Levels of Methanol and Formic Acid from Chemistry Tests

Purpose:

To use the osmolal gap and arterial pH to evaluate a patient with methanol poisoning.

Specialty:

Toxicology
Emergency Medicine
Critical Care
Ophthalmology

Objective:

clinical diagnosis, including family history for genetics, laboratory tests

ICD-10:

T57.1

Description:

Methanol is metabolized by alcohol dehydrogenase to formaldehyde, which is then metabolized to formic acid. This results in a metabolic acidosis and increase in the osmolal gap. The osmolal gap can be used to estimate the plasma methanol level, while the arterial pH correlates with the formic acid concentration.

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