Naphthalene Poisoning following Ingestion of Mothballs: A Case Report

Kundra, Tanveer Singh; Bhutatani, Vikas; Gupta, Rimple; Kaur, Parminder

doi:10.7860/jcdr/2015/15503.6274

Cited by 21 publications

(25 citation statements)

References 5 publications

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“…Usually, haemolysis is precipitated in susceptible individuals, for instance, G6PD-deficient individuals, as they have low tolerance to oxidative stress 9 10. Naphthalene being a potent oxidant oxidises Hb to MetHb.…”

Section: Discussionmentioning

confidence: 99%

Naphthalene ball poisoning: a rare cause of acquired methaemoglobinaemia

et al. 2016

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A 15-year-old boy presented to emergency services with accidental naphthalene ball ingestion. Following consumption he developed methaemoglobinaemia, massive intravascular haemolysis and acute kidney injury. He had no history suggestive of congenital haemoglobin M disease. Development of severe methaemoglobinaemia and intravascular haemolysis is quite unusual after consumption of a single ball of naphthalene. The patient was managed with ascorbic acid and intravenous N-acetyl cysteine. He also required haemodialysis for acute kidney injury that developed secondary to pigment nephropathy.

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Section: Discussionmentioning

confidence: 99%

Naphthalene ball poisoning: a rare cause of acquired methaemoglobinaemia

et al. 2016

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“…The latter group includes polycyclic aromatic hydrocarbons (PAHs), which have been associated with a variety of adverse health effects in humans and wildlife 75 , 76 . Among the known harmful PAHs, toluene is a neurotoxicant used in glue 77 , benzo[a]pyrene (B[a]P) is both a neurotoxicant 78 and a potent carcinogen 79 , 80 , while naphthalene can cause hemolytic anemia and is the active substance in mothballs 81 . Several of the 16 PAHs identified by the US Environmental Protection Agency as priority pollutants are present in cigarette smoke, such as B[a]P, pyrene, and phenanthrene 82 , but possible relations between PAH exposure and AD remain largely unexplored 72 .…”

Section: Introductionmentioning

confidence: 99%

“…2 ), i.e., toluene, naphthalene, phenanthrene, pyrene, and B[a]P, and iii) the metal ions Pb(II), Pb(IV), Cd(II) and Cr(III). Many of these compounds are associated with adverse biological effects on survival, growth, development, reproduction, metabolism, and tumor formation 75 , 79 – 81 , and neurotoxic effects in particular have been associated with exposures to toluene 77 , B[a]P 78 , and several of the metals found in cigarette smoke 54 , 83 – 86 . The results presented below show that some of these substances may also contribute to AD pathogenesis and progression, by modulating the Aβ fibril formation process or/and by inducing ROS damage.…”

Section: Introductionmentioning

confidence: 99%

Alzheimer’s disease and cigarette smoke components: effects of nicotine, PAHs, and Cd(II), Cr(III), Pb(II), Pb(IV) ions on amyloid-β peptide aggregation

Wallin

Sholts

Österlund

et al. 2017

Sci Rep

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Cigarette smoking is a significant risk factor for Alzheimer’s disease (AD), which is associated with extracellular brain deposits of amyloid plaques containing aggregated amyloid-β (Aβ) peptides. Aβ aggregation occurs via multiple pathways that can be influenced by various compounds. Here, we used AFM imaging and NMR, fluorescence, and mass spectrometry to monitor in vitro how Aβ aggregation is affected by the cigarette-related compounds nicotine, polycyclic aromatic hydrocarbons (PAHs) with one to five aromatic rings, and the metal ions Cd(II), Cr(III), Pb(II), and Pb(IV). All PAHs and metal ions modulated the Aβ aggregation process. Cd(II), Cr(III), and Pb(II) ions displayed general electrostatic interactions with Aβ, whereas Pb(IV) ions showed specific transient binding coordination to the N-terminal Aβ segment. Thus, Pb(IV) ions are especially prone to interact with Aβ and affect its aggregation. While Pb(IV) ions affected mainly Aβ dimer and trimer formation, hydrophobic toluene mainly affected formation of larger aggregates such as tetramers. The uncharged and hydrophilic nicotine molecule showed no direct interactions with Aβ, nor did it affect Aβ aggregation. Our Aβ interaction results suggest a molecular rationale for the higher AD prevalence among smokers, and indicate that certain forms of lead in particular may constitute an environmental risk factor for AD.

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“…Hemolytic anemia and methemoglobinemia is characteristic of naphthalene poisoning. Severe neutrophilic leukocytosis and acute kidney injury is also observed [ 4 ]. Hyperbilirubinemia, with indirect predominance, elevated lactate dehydrogenase and decreased haptoglobin levels are seen [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Treatment of naphthalene toxicity is supportive, including mechanical ventilation and blood pressure support with the use of inotropes [ 4 ]. In mild cases, if the causative agent is removed, the methemoglobin may return to hemoglobin within a few days [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Naphthalene Toxicity: Methemoglobinemia and Acute Intravascular Hemolysis

Volney¹,

Tatusov

Yen³

et al. 2018

Cureus

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Naphthalene poisoning is a rare form of toxicity that may occur after ingestion, inhalation, or dermal exposure to naphthalene-containing compounds such as mothballs. Clinically, patients present with acute onset of dark brown urine, watery diarrhea, and non-bloody bilious vomiting 48-96 hours after exposure. Vital sign abnormalities include fever, tachycardia, hypotension, and persistent pulse oximetry readings of 84%-85% despite oxygen supplementation. Laboratory workup demonstrates hyperbilirubinemia with indirect predominance, hemolytic anemia, methemoglobinemia, and renal dysfunction. Treatment options include supportive care, red cell transfusion, ascorbic acid, methylene blue, and N-acetylcysteine. We present a case of naphthalene toxicity in a 20-year-old autistic male, who improved with supportive care, red blood cell transfusion, and ascorbic acid.

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Naphthalene Poisoning following Ingestion of Mothballs: A Case Report

Cited by 21 publications

References 5 publications

Naphthalene ball poisoning: a rare cause of acquired methaemoglobinaemia

Naphthalene ball poisoning: a rare cause of acquired methaemoglobinaemia

Alzheimer’s disease and cigarette smoke components: effects of nicotine, PAHs, and Cd(II), Cr(III), Pb(II), Pb(IV) ions on amyloid-β peptide aggregation

Naphthalene Toxicity: Methemoglobinemia and Acute Intravascular Hemolysis

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