Does Exposure to Nitrate in Drinking Water Contribute Anything the Effect of Water Chlorination on Children Methemoglobin Levels?

Sadeq, Mina; Abouqal, Rédouane; Attarassi, Benaissa; Lakranbi, Mohammed; Aouad, Rajae El; Idrissi, L.

doi:10.4236/jep.2012.32021

Cited by 1 publication

(1 citation statement)

References 18 publications

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“…The manual of the blood gas analytic instrument reported possible interference in the measurement of chloride in the presence of halogens in the sample (e.g., Br-, I-, ClO4-) [16]. Substances such as potassium bromate, chlorates, nitrites/nitrates may be present in drinking water after purification processes [17]; indeed, few cases of acquired methemoglobinemia in children and pregnant women are reported because of chronic drinking water intake [18,19]. Based on these findings, we hypothesized a possible intoxication by tap water and we recommended using bottled water.…”

Section: Discussionmentioning

confidence: 99%

Suspected Drinking Water Poisoning in a Domestic Kitten with Methemoglobinemia

Fidanzio

Corsini

Spindler

et al. 2021

Veterinary Sciences

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A 4-month-old male indoor cat was referred for dyspnea, mental dullness and weakness, which appeared two days earlier. The cat had been adopted at 3 months of age. Physical exam showed cyanosis, dyspnea and mild hypothermia. The “spot test” was supportive of methemoglobinemia. Co-oximetry blood gas analysis revealed severe methemoglobinemia (81,40%), severe hyperchloremia and mild hyponatremia. CBC, biochemistry and urinalysis were within normal limits, blood smear showed the presence of Heinz bodies. Treatment was instituted with oxygen therapy, methylene blue 1% solution, ascorbic acid, intravenous fluid therapy. The clinical course was favorable with rapid improvement of cyanosis and methemoglobinemia (4,2%). Acquired methemoglobinemia was hypothesized. Two weeks after discharge the cat was asymptomatic but mild methemoglobinemia (15,60%) and hyperchloremia were evident. Exposure to oxidants contained in drinking water was suspected so the owners were instructed to use bottled water only. One month later the cat was asymptomatic, and methemoglobinemia and chloremia were within normal limits. Even if a congenital form due to cytochrome b5 reductase deficiency cannot be ruled out, drinking water intoxication is the most likely cause of methemoglobinemia in this cat.

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Section: Discussionmentioning

confidence: 99%