Methylene blue for refractory anaphylaxis—is it a magic bullet?

Menezes, Ritesh G.; Jena, Narendra Nath; Thirumalaikolundusubramanian, Ponniah

doi:10.1016/j.ajem.2013.03.032

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…Methylene blue is an oxidant; and thus can result in hemolysis and, paradoxically, methemoglobinemia in patients with G6PD deficiency. So although it is considered as the first line therapy for drug induced/poisoning related MetHb, a lot of factors need to be considered before using like availability, G6PD status, dose, duration, side effects (rebound methemoglobenemia and hemolysis) [9,10]. Automated therapeutic red cell exchange which is a much safe, efficacious and promising treatment modality with huge potential can be used in such cases assuring prompt relief following a single or may be a 2 day sitting.…”

Section: Discussionmentioning

confidence: 99%

Role of Automated Therapeutic Red Cell Exchange in the Setting of Acute Methemoglobinemia: Our Experience

Khetarpal

Kotwal

2017

Indian J Hematol Blood Transfus

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Methemoglobinemia, an altered state of hemoglobin resulting in impaired oxygen delivery to the tissues can be congenital or following exposure/ingestion of various oxidant drugs or toxins. One of the earliest signs of methemoglobinemia is generalized cyanosis not improved on oxygen supplementation and presence of normal PO on acid blood-gas analysis. Here, we report two cases of acquired methemoglobinemia following poisoning and our experience of managing them with automated therapeutic red cell exchange.

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Section: Discussionmentioning

confidence: 99%

Role of Automated Therapeutic Red Cell Exchange in the Setting of Acute Methemoglobinemia: Our Experience

Khetarpal

Kotwal

2017

Indian J Hematol Blood Transfus

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“…It has assumed a significant role, with diverse applications in clinical practice, but is fraught with risks of side-effects. [2] Methylene blue is reduced to leukomethylene blue by erythrocyte methemoglobin reductase in the presence of nicotinamide adenine dinucleotide phosphate (NADPH). Further, leukomethylene blue reduces methemoglobin to oxyhemoglobin.…”

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confidence: 99%