Therapeutic Response to Folinic Acid in Me-thanol Poisoning Epidemic in Shiraz

Background: Methanol poisoning may result to death and permanent complications, sporadic cases of methanol poisoning are fairly rare and the largest experience are generally gained from managing methanol intoxication epidemics. The main metabolite of methanol is acid formic that is the prime metabolite responsible for toxic effects of methanol and since folate dependent systems are responsible for the oxidation of formic acid to CO2 and water. It is believed that administration of folic acid enhances the metabolism of formate. Though therapeutic effects of folic or folinic acid has never been fully tested in clinical trails in human. Our objective was to evaluate therapeutic effect of folinic acid in methanol poisoned persons. Methods: In recent methanol poisoning epidemic due to "bootleg" Liquor consumption in Shiraz at 2004, Sixty-two patients have hospitalized. Folinic acid was administered to 19 patients and therapeutic effect of folinic acid was studied. Results: There was no significant difference between two groups of patients and number of decreased visual acuity, renal function, hospital stays and needs to bicarbonate therapy and hemodialysis. The only effect was decreasing acidosis in folate treated patients. Conclusion: Regardless of prior animal studies and case reports, with attention to our study limitation we didn’t found significant protective effect of folinic acid infusion among methanol poisoning patients. The only effect was decreasing acidosis in folate received patients. Further studies in optimal situation is needed for definite judgment.