Rrefractory Metabolic Acidosis in a Diabetic Patient : A case of Unsuspected Methanol Intoxication

  • Uzzwal Kumar Mallick Registrar, Dept. of CCM, National Institute of Neurosciences and Hospital, Dhaka
  • S M Hossain Shahid Consultant & Head of ICU, Anwer Khan Modern Medical College Hospital, Dhaka
  • Mohammad Omar Faruq Chief Consultant, General ICU and Emergency Dept. United Hospital, Dhaka
  • Mohammad Asaduzzaman Assistant registrar, Dept. of CCM, National Institute of Neurosciences and Hospital, Dhaka.
  • Amina Sultana Junior Consultant, General ICU, United Hospital, Dhaka
  • Aflatun Asha RMO, ICU, Anwer Khan Modern Medical Collehe Hospital, Dhaka
Keywords: Metabolic Acidosis, Sustained Low Efficiency Dialysis (SLED), Methanol intoxication, Diabetic Ketoacidosis (DKA)

Abstract

We present a case of a 45 years old male, diabetic and hypertensive who was admited into hospital with a history ofrestlessness, blurring of vision and breathlessness for one day. Inspite of conservative treatment for 10 hours, hisgeneral condition gradually detoriated and he was shifted to ICU. He was kept on mechanical ventilator. Hislaboratory results showed severe high anion gap metabolic acidosis not corrected by sodibicarb and adequate fluidresuscitation. MRI of brain showed bilateral putamenal lesion suspecting methanol intoxication. His acidosis persistedand after giving 3 sessions of Sustained Low Efficiency Dialysis (SLED), metabolic acidosis was corrected withnormalization of renal function. After six months in a follow-up, patient complained of total blindness and fundalphotography showed bilateral optic atrophy.

Bangladesh Crit Care J September 2019; 7(2): 111-112

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Abstract
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Published
2019-10-08
How to Cite
Mallick, U. K., Shahid, S. M. H., Faruq, M. O., Asaduzzaman, M., Sultana, A., & Asha, A. (2019). Rrefractory Metabolic Acidosis in a Diabetic Patient : A case of Unsuspected Methanol Intoxication. Bangladesh Critical Care Journal, 7(2), 111-112. https://doi.org/10.3329/bccj.v7i2.43464
Section
Case Reports