Pediatric occult methanol intoxication with hyperammonemia

Methanol is metabolized by alcohol and aldehyde dehydrogenases to formic acid, which leads to metabolic acidosis, retinopathy, and damage to optic nerves and basal ganglia. Ammonia accumulation can occur with normal hepatocellular function through over production with gram negative urease-producing organism-induced sepsis, multiple myeloma, some chemotherapeutics, post-bone marrow transplantation, ureterosigmoidostomy, and states of increased catabolism [8,9].