A case of methaemoglobinaemia.

Abstract

SUMMARYMethaemoglobinaemia is rare but should be considered in cases of cyanosis unresponsive to oxygen therapy. An example of this is given involving the accidental ingestion of Amyl Nitrite. CASE REPORTA 20-year-old girl attended the accident and emergency department following a collapse. She was alert and orientated, but complained of headache. Her blood pressure was 80/40 mmHg. Her most striking feature was a blue-grey discolouration of her skin. Oxygen therapy made no difference to her appearance, although blood gas analysis revealed a Pao2 of 46 kPa.She had been attending a Halloween party, but was not wearing make-up, and admitted taking 'Poppers' (Amyl Nitrite). Instead of inhaling the vapour, she had swallowed the liquid. Amyl Nitrite may produce methaemoglobinaemia, and this was confirmed by analysis of her blood which revealed a value of 30% methaemoglobin. When dropped on to a white sheet, a sample of her blood produced the characteristic chocolate colouration, which is a qualitative test for methaemoglobin. Gastric lavage was performed and she was resuscitated with intravenous colloid and intravenous Methylene Blue. No further complications followed and she was discharged the following day. DISCUSSIONMethaemoglobinaemia is characterized by increased amounts of haemoglobin where

The protective potential of Yucca schidigera (Sarsaponin 30®) against nitrite-induced oxidative stress in rats

“…Increased formation of MetHb inhibits oxygen transport in blood, and its saturation leads to ischemia, cyanosis, and irreversible damage in the tissues and ultimately to mortality [32]. Gonchar et al [4] demonstrated that MetHb formation increased in rat blood 50 min after injection of NaNO 2 60 mg/kg, s.c.…”

Teenage toxins: Recreational poisoning in the adolescent

“…There have been many reports of methaemoglobinaemia caused by recreational abuse or inadvertent ingestion of liquid nitrites (usually amyl or butyl nitrite) 29–35 . Methaemoglobinaemia is a disorder affecting the oxygen‐carrying capacity of haemoglobin.…”

“…There have been many reports of methaemoglobinaemia caused by recreational abuse or inadvertent ingestion of liquid nitrites (usually amyl or butyl nitrite). [29][30][31][32][33][34][35] Methaemoglobinaemia is a disorder affecting the oxygen-carrying capacity of haemoglobin. The acquired syndrome occurs in the presence of an oxidant, usually drug-induced, which converts the ferrous (Fe ++ ) heme moiety of haemoglobin to the ferric (Fe +++ ) form.…”

Methaemoglobinaemia associated with the use of cocaine and volatile nitrites as recreational drugs: a review

“…Subsequent to this, there have been 25 reports of methaemoglobinaemia secondary to inhalation and/or ingestion of volatile nitrites, with methaemoglobin concentrations of between 17.8% and 94% [2–21]. The majority of these cases survived, and a proportion were treated with methylthioninium chloride.…”

“…The majority of these cases survived, and a proportion were treated with methylthioninium chloride. The cases where the individual survived are summarized in Table 2[1–21] and the three reported deaths are discussed in more detail later in this article [22–24]. For the interest of the reader, we have discussed three of the non‐fatal cases in more detail below.…”