Methanol toxicity from inhalational abuse of a methyl acetate-containing nail polish remover.
Mitchell D'Aloia, Bernard Weigel, Brian Bush
✦ AI-curated · Sources linked
Case in brief
A 47-year-old woman presented to the emergency department after losing consciousness due to inhalational abuse of a nail polish remover containing methyl acetate. Laboratory tests revealed elevated anion-gap metabolic acidosis consistent with methanol toxicity, confirmed by a serum methanol concentration of 35 mg/dL. Treatment included fomepizole and hemodialysis, leading to normalization of her acid-base status and resolution of symptoms by hospital day 2.
What made this case unusual
This case highlights acute methanol poisoning resulting from inhalation of methyl acetate, an atypical route of exposure that is not commonly associated with methanol toxicity.
Diagnostic / clinical pearl
Clinicians should be aware that inhalation of products containing methyl acetate can lead to methanol toxicity, necessitating prompt recognition and management.
Why it matters
This case emphasizes the need for thorough product ingredient review in emergency settings to prevent misdiagnosis and ensure appropriate treatment for toxic exposures.