Eight fatalities due to drinking methanol-tainted alcohol in Pakistan: A case report

Methanol has a widespread commercial use as a solvent in paints, varnishes, anti-freeze solutions and denaturant for ethanol. Exposure may occur due to accidental, suicidal ingestion or as a result of consuming adulterated liquor. Fatalities were reported in Pakistan in an incident after consuming methanol-tainted liquor. Postmortem specimens of eight deceased males, ages ranged from 16 to 40 yrs, were submitted for toxicological analysis. Presence of blurred vision, severe metabolic acidosis with decreased serum bicarbonate level, increased serum osmolality and mean anion gap before death strongly suggested methanol toxicity. Headspace gas chromatograph coupled to flame ionization detector was used to quantify volatiles in blood and stomach contents of victims. Lethal levels of methanol in addition to ethanol were detected. The most probable mechanism of methanol-related deaths was sudden cessation of respiration due to inhibition of cytochrome oxidase that led to histotoxic hypoxia.