High-dose vitamin C as treatment of methemoglobinemia

Lee, Kyung-Woo; Park, Sin-Youl

doi:10.1016/j.ajem.2014.05.030

Cited by 18 publications

(18 citation statements)

References 20 publications

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“…One notable concern for this treatment is that high doses increase urinary excretion of oxalate, which has been reported to cause oxalate nephropathy in patients with renal impairment. 9 …”

Section: Discussionmentioning

confidence: 99%

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Methemoglobinemia Induced By Ingesting Lava Lamp Contents

Funke

Fischetti

Rodino

et al. 2018

CPC-EM

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A patient presented after ingesting the contents of a lava lamp that he believed to contain alcohol. It was later discovered that this product was comprised of 76% calcium nitrate, leading to his subsequent development of methemoglobinemia. This disease is a medical emergency secondary to poor transportation of oxygen and resultant tissue hypoxic effects. Therefore, having high suspicion for this disease process in patients with toxic ingestions, understanding the proper diagnosis, and promptly starting treatment are all critical actions for emergency physicians.

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“…One notable concern for this treatment is that high doses increase urinary excretion of oxalate, which has been reported to cause oxalate nephropathy in patients with renal impairment. 9 …”

Section: Discussionmentioning

confidence: 99%

“…Additionally, ascorbic acid requires multiple doses much more frequently. 9 , 10 Finally, in severe cases of methemoglobinemia, exchange transfusion and hyperbaric oxygen can also be used as adjunctive or monotherapy. 11 , 12 …”

Section: Discussionmentioning

confidence: 99%

Methemoglobinemia Induced By Ingesting Lava Lamp Contents

Funke

Fischetti

Rodino

et al. 2018

CPC-EM

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“…Vitamin C (ascorbic acid) has also been reported as a potential treatment for methemoglobinemia. 6,9 It is postulated that the antioxidant potential of vitamin C aids in reduction of heme to its ferrous state. 6,9 Current evidence for effective use of vitamin C is lacking and, if available, methylene blue should be first-line therapy.…”

Section: Discussionmentioning

confidence: 99%

“…6,9 Current evidence for effective use of vitamin C is lacking and, if available, methylene blue should be first-line therapy. 3,9…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Hemoglobin M Disease in a Toddler Presenting With Hypoxemia and Hemolysis

Picca

Ruthford

Ghanim

et al. 2019

Clin Pediatr (Phila)

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“…Ascorbic acid, better known as vitamin C, is one alternative due to its antioxidant effects. 22 Other investigatory therapies include N-acetylcysteine 23 and cytochrome P-450 inhibitors in dapsoneinduced methemoglobinemia, 24 although studies remain limited. Treating the underlying cause behind the production of methemoglobin, such as the oxidative stress in G6PD deficiency, can also be a form of treatment.…”

Section: Discussionmentioning

confidence: 99%

Sometimes, It’s Just Black and White: Dark Urine and Pallor in a 2-Year-Old Boy

Wadowski

Chang

Khan

et al. 2016

Hospital Pediatrics

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A 2-year-old Chinese boy was admitted to the hospital after 2 days of pallor and fatigue and 1 day of dark urine. There was no recent history of illness, although his mother reported a 1-week history of intermittent, subjective fevers. There was no history of recent travel, no history of recent trauma, no sick contacts, no pertinent family history, no changes in diet, and no medications. His past medical history was significant for self-limited nosebleeds, which had increased in frequency over the few days before admission. On examination, the patient was afebrile and tachycardic, with an oxygen saturation of 88% on room air. He was pale and tired-appearing on arrival. He was in no respiratory distress, and there was no hepatosplenomegaly or lymphadenopathy. His skin examination was notable for jaundice, but there were no bruises, petechiae, or rash. He was noted to pass cola-colored urine while in the hospital. His chest radiograph was normal. Laboratory evaluation revealed a normal serum electrolyte level and normal serum urea nitrogen and creatinine levels. A complete blood count (CBC) revealed the following: a white blood cell count of 20,700 per mL with normal differential, hemoglobin of 4.1 g/dL, hematocrit of 11.8%, a platelet count of 365 000 per mL, a mean corpuscular volume of 88.2 femtoliters, and a red cell distribution width of 20.5%. Question What Are the Current Recommendations for the Evaluation of Anemia in the Pediatric Population? Discussion Anemia is estimated to affect up to 20% of the American population during childhood. 1 It can be defined on the basis of age-and sex-specific percentile criteria for hemoglobin concentration. The Centers for Disease Control and Prevention, for example, uses the fifth percentile and below to define anemia, resulting in a lower limit of normal range of 11.0 to 11.9 g/dL for children under age 12 and 12.5 to 13.5 g/dL for children ages 12 to 18 years. 2 Reference ranges for neonates vary considerably on the basis of factors such as gestational age and day of life, although standardized reference values have been established. 3 The diagnostic approach to anemia combines a thorough history and physical examination with laboratory testing aimed at identifying which cell lines are affected, characterizing the patient' s erythrocytes, and differentiating between aplastic and consumptive processes. The CBC, which is used to confirm the presence of anemia, will also reveal whether the patient has abnormalities in the leukocyte or thrombocyte lines. Several acquired or inherited diseases can contribute to peripheral cytopenia, and many,

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High-dose vitamin C as treatment of methemoglobinemia

Cited by 18 publications

References 20 publications

Methemoglobinemia Induced By Ingesting Lava Lamp Contents

Methemoglobinemia Induced By Ingesting Lava Lamp Contents

Diagnosis of Hemoglobin M Disease in a Toddler Presenting With Hypoxemia and Hemolysis

Sometimes, It’s Just Black and White: Dark Urine and Pallor in a 2-Year-Old Boy

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