- [1,4-diaminobenzene and diphenylamine-induced severe methemoglobinaemia treated by hyperbaric oxygen therapy - Case report]. [Journal Article]
- MPMed Pr 2018 May 22; 69(3):345-350
- Methemoglobin is an oxidized form of hemoglobin that is not capable of carrying oxygen. Exposure to exogenous oxidizing agents can cause severe methemoglobinemia and subsequent hypoxia. This article ...
Methemoglobin is an oxidized form of hemoglobin that is not capable of carrying oxygen. Exposure to exogenous oxidizing agents can cause severe methemoglobinemia and subsequent hypoxia. This article presents the rare case of a 23-year old patient with methemoglobinemia of 54.2% of total hemoglobin, induced by workplace exposure to 1,4-diaminobenzene and diphenylamine. Following the hyperbaric oxygen therapy the patient was discharged in good general condition and referred to a district hospital for observation. Med Pr 2018;69(3):345-350.
- Poisoning associated with inappropriate use of a eutectic mixture of lidocaine and prilocaine before laser-assisted hair removal: about 3 cases. [Journal Article]
- IJInt J Legal Med 2018 May 21
- CONCLUSIONS: Health authorities should publish explicit recommendations targeting users and prescribers with particular emphasis on the maximal surface area of application.
- Methemoglobinemia: A Girl with 'Chocolate Brown' Colored Blood. [Journal Article]
- IJIndian J Pediatr 2018 May 18
- Dapsone: An Update. [Journal Article]
- IJIndian J Lepr 2016; 87(4):233-239
- Dapsone is an extensively Used drug for the treatment of leprosy as well as'some other clinical problems worldwide: Its use has been predicted to increase further, especially in non leprosy condition...
Dapsone is an extensively Used drug for the treatment of leprosy as well as'some other clinical problems worldwide: Its use has been predicted to increase further, especially in non leprosy conditions. Treatment with Dapsone is sometimes known'to be associated with side-effects, which include gastrointestinal intolerance, haemolysis, methaemoglobinaemia, agranulocytosis, psychosis, peripheral neuritis and varied dermatological conditions, varying from simple rash to severe life threatening epidermolytic reactions and Dapsone hypersensitivity syndrome (DHS). DHS is a rare delayed hypersensitivity reaction involving multiple organs. the condition is associated with high morbidity and is potentially fatal. In this article, the focus is on etiopathogenesis, diagnosis and management of DHS. Awareness of the varied presentation/s of the condition, early recognition, withdrawal of the drug and proper management helps in rapid reduction in morbidity and preventing fatalities associated with it.
- [Cyanosis in 14-year-old patient. Methemoglobinemia: case report]. [Journal Article]
- AAArch Argent Pediatr 2018 06 01; 116(3):e429-e432
- The bluish coloration of skin and mucous membranes, called as cyanosis, could be explained by high reduced hemoglobin in the capillaries, or the presence of elevated methemoglobin concentration. It i...
The bluish coloration of skin and mucous membranes, called as cyanosis, could be explained by high reduced hemoglobin in the capillaries, or the presence of elevated methemoglobin concentration. It is important to think of methemoglobinemia as a differential diagnosis in a cyanotic patient who does not respond to oxygen administration once cardiorespiratory causes are discarded; since it requires other diagnostic methods and specific treatment. We described a case of cyanosis in a fourteen-year-old adolescent with probable congenital methemoglobinemia. We discussed their probable causes, clinic presentation, diagnosis and treatment.
- Severe decrease in SpO2 and methemoglobinemia following subareolar isosulfan blue administration and clinical relevance. [Journal Article]
- TJTurk J Surg 2018; 34(1):74-76
- The level of axillary lymph node involvement in breast cancer is a critical decision factor for adjuvant therapy and the most important indicator of prognosis and survival. Sentinel lymph node biopsy...
The level of axillary lymph node involvement in breast cancer is a critical decision factor for adjuvant therapy and the most important indicator of prognosis and survival. Sentinel lymph node biopsy is a minimally invasive technique with low morbidity in axillary staging of breast cancer. Radiocolloid substances (Technetium-99m) and/or blue dyes such as methylene blue or isosulfan blue are used during sentinel lymph node biopsy. Isosulfan blue stain is frequently used in sentinel lymph node biopsy and rarely causes complications. The present case report presents a severe decrease in SpO2 due to methemoglobinemia following isosulfan blue administration as well as skin and urine signs and inconsistency with clinical picture in a 67-year-old, 77 kg, ASA II female case who underwent sentinel lymph node biopsy under general anesthesia.
- Does nitrite and nitrate levels in drinking water impact the health of people in Dakahlia governorate, Egypt? [Journal Article]
- ESEnviron Sci Pollut Res Int 2018 May 07
- A total of 1291 drinking water samples were examined for nitrite and nitrate during 6 months from December, 2015 to May, 2016 at 17 cities of Dakahlia governorate (Nile Delta, north of Egypt), and th...
A total of 1291 drinking water samples were examined for nitrite and nitrate during 6 months from December, 2015 to May, 2016 at 17 cities of Dakahlia governorate (Nile Delta, north of Egypt), and the results were utilized for assessment of health risk of the exposure from drinking water by calculating average daily intake (ADI), hazard quotient (HQ), and the hazard index (HI). The nitrite and nitrate in drinking water had a concentration range of 0.030-0.113 and 2.41-8.70 mg L-1, with mean values of 0.059 ± 0.014 and 5.25 ± 1.61 mg L-1, respectively. Nitrite and nitrate levels in rural areas and ground water samples were significantly higher than that in the urban ones. None of the analyzed samples exceeded WHO guideline values that set out to prevent methemoglobinemia. The values of HQ and HI for all age groups do not exceed unity indicating a low risk of methaemoglobinaemia for the population in this area. Results of the present study indicate that there is no health risk of residents from nitrite and nitrate through drinking water in the studied area. However, the other sources of exposure to nitrite and nitrate should be investigated in further studies.
- Congenital methemoglobinemia misdiagnosed as polycythemia vera: Case report and review of literature. [Journal Article]
- HRHematol Rep 2018 Mar 02; 10(1):7221
- Methemoglobinemia is a rare overlooked differential diagnosis in patients presented with cyanosis and dyspnea unrelated to cardiopulmonary causes. Our patient is 29 year old Indian non-smoker male, h...
Methemoglobinemia is a rare overlooked differential diagnosis in patients presented with cyanosis and dyspnea unrelated to cardiopulmonary causes. Our patient is 29 year old Indian non-smoker male, his story started 6 months prior to presentation to our center when he had generalized fatigue and discoloration of hands. He presented with persistent polycythemia with elevated hemoglobin level. The patient was misdiagnosed in another center as polycythemia and treated with Imatinib. The diagnosis of PV was revisited and ruled out in view of negative JAK2, normal erythropoietin level and absence of features of panmyelosis. Clinical cyanosis and lowoxygen saturation in the presence of normal arterial oxygen tension was highly suggestive of methemoglobinemia. Arterial blood gas revealed a methemoglobin level of 38% (normal: 0-1.5%). Cytochrome B5 reductase (Methemoglobin reductase B) was deficient at level of <2.6 U/g Hb) (normal: 6.6-13.3), consistent with methemoglobin reductase (cytochrome b5) deficiency and hence the diagnosis of congenital methemoglobinemia was established. The role of Imatinib in provoking methemoglobinemia is questionable and association between Imatinib and methemoglobinemia never described before. In our case, there were no other offending drugs in aggravating the patients' symptoms and cyanosis. The patient started on Vitamin C 500 mg once daily for which he responded well with less cyanosis and significant reduction of methemoglobin level. Congenital methemoglobinemia is a rare underreported hemoglobin disease and often clinically missed. Upon extensive review of English literature for cases of congenital methemoglobinemia due to deficiency of cytochrome b5 reductase, we found 23 cases diagnosed as type I (including the case reported here). 17 cases (~74%) of type I and 6 cases (27%) of type II. There is male predominance 73% versus 26% in females. Almost half of reported cases 12 cases (52%) are Indian, 2 Japanese, 3 English, 2 Arabic, one case Spanish and one case Italian. For type I, the median calculated age is 31 years with cyanosis and shortness of breath being the most common sign and symptoms. For type II: Six cases were reported in English literature, all in pediatric age group with median calculated age at presentation is 6 years with neurologic manifestations and mental retardation are the most common type II associated symptoms. Due to lack of systematic epidemiological studies, congenital methemoglobinemia is under diagnosed as it is under investigated and usually overlooked especially when presenting in adulthood and in absence of obvious acquired agents.
- [Methemoglobinemia after inhalation of poppers]. [Journal Article]
- MKMed Klin Intensivmed Notfmed 2018 Apr 17
- CONCLUSIONS: Stimulating compounds such as volatile nitrites (poppers) may lead to potentially fatal methemoglobinemia. Swift and accurate diagnosis and targeted therapy with methylene blue can lead to rapid recovery.
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- A new mutation of congenital methemoglobinemia exacerbated after methylene blue treatment. [Journal Article]
- AMAcute Med Surg 2018; 5(2):199-201
- CONCLUSIONS: We report a novel variant of congenital methemoglobinemia that deteriorated after methylene blue treatment.