https://doi.org/10.4081/ecj.2021.9089
An acquired acute methemoglobinemia from dietary sources: Case reports and literature review
Submitted: 7 May 2020
Accepted: 11 July 2020
Published: 18 March 2021
Accepted: 11 July 2020
Abstract Views: 3353
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Methemoglobinemia is an alteration of the oxidative state of hemoglobin. When methemoglobin values rise above 10%, the symptoms and signs related to this condition appear, such as cyanosis, respiratory problems, fatigue and headache. Acquired methemoglobinemia is characterized by the sudden onset of cyanosis in a previous healthy child, which can be due to exposure to medications or chemical substances including nitrates, copper, sulfates, chlorites, chloramines and chlorates which can be present in food and water. We illustrate two cases of acquired methemoglobinemia related to nitrate ingestion from a vegetable source.
Baraka AS, Ayoub CM, Yazbeck-Karam V, et al. Prophylactic methylene blue in a patient with congenital methemoglobinemia. Can J Anaesth 2005;52:258-61.
DOI: https://doi.org/10.1007/BF03016060
Meier J, Pape A, Lauscher P, et al. Hyperoxia in lethal methemoglobinemia: Effects on oxygen transport, tissue oxygenation, and survival in pigs. Crit Care Med 2005;33:1582-8.
DOI: https://doi.org/10.1097/01.CCM.0000170187.39166.FF
Filer LJ, Lower CU, & Barness LA: Infant methemoglobinemia. The role of dietary nitrate. Pediatrics 1970;46:475-8.
Curry S. Methemoglobinemia. Ann Emerg Med 1982;11:214-21.
DOI: https://doi.org/10.1016/S0196-0644(82)80502-7
Ludlow JT, Wilkerson RG, Nappe TM. Methemoglobinemia. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan. 2020 Sep 4.
Bradberry SM. Occupational methaemoglobinaemia. Mechanisms of production, features, diagnosis and management including the use of methylene blue. Toxicol Rev 2003;22:13-27.
DOI: https://doi.org/10.2165/00139709-200322010-00003
Ash-Bernal R, Wise R, Wright SM. Acquired methemoglobinemia: a retrospective series of 138 cases at 2 teaching hospitals. Med (Baltimore) 2004;83:265-73.
DOI: https://doi.org/10.1097/01.md.0000141096.00377.3f
Chegondi M, Ten I, Totapally B. Dapsone-induced Methemoglobinemia in a Child with End-stage Renal Disease: A Brief Review. Cureus 2018;10:e2513.
DOI: https://doi.org/10.7759/cureus.2513
Guay J. Methemoglobinemia Related to Local Anesthetics: A Summary of 242 Episodes. Anesth Analg 2009;108:837-45.
DOI: https://doi.org/10.1213/ane.0b013e318187c4b1
Cho YS, Chung BY, Park CW, Kim HO. Seizures and Methemoglobinemia After Topical Application of Eutectic Mixture of Lidocaine and Prilocaine on a 3.5-Year-Old Child with Molluscum Contagiosum and Atopic Dermatitis. Pediatr Dermatol 2016;33:e284-5.
DOI: https://doi.org/10.1111/pde.12927
Martínez de Zabarte Fernández JM, García Íñiguez JP, Domínguez Cajal M. Metahemoglobinemia in infants over one year. Med Clin (Barc) 2018;151:278-80.
DOI: https://doi.org/10.1016/j.medcli.2017.12.009
Sanchez-Echaniz J, Benito-Fernández J, Mintegui-Raso S. Methemoglobinemia and consumption of vegetables in infants. Pediatrics 2001;107:1024-8.
DOI: https://doi.org/10.1542/peds.107.5.1024
Cannata G, Abate L, Scarabello C, et al. The Dose Makes the Poison: A Case Report of Acquired Methemoglobinemia. Int J Environ Res Public Health 2020;17.
DOI: https://doi.org/10.3390/ijerph17061845
Kennedy N, Smith CP, McWhinney P. Faulty sausage production causing methaemoglobinaemia. Arch Dis Child 1997;76:367–8.
DOI: https://doi.org/10.1136/adc.76.4.367
Sutton M, Jeffrey B. Acquired acute methaemoglobinaemia from amyl nitrite inhalation. J Emerg Nurs 1992;18:8–9.
Wu L-T, Schlenger WE, Ringwalt CL. Use of nitrite inhalants (“poppers”) among American youth. J Adolesc Health 2005;37:52-60.
DOI: https://doi.org/10.1016/j.jadohealth.2004.06.007
Shamir MY, Avramovich A, Smaka T. The current status of continuous noninvasive measurement of total, carboxy, and methemoglobin concentration. Anesth Analg 2012;114:972-8
DOI: https://doi.org/10.1213/ANE.0b013e318233041a
Skold A, Cosco DL, Klein R. Methemoglobinemia: Pathogenesis, diagnosis, and management. South Med J 2011;104:757–61.
DOI: https://doi.org/10.1097/SMJ.0b013e318232139f
Cortazzo JA, Lichtman AD. Methemoglobinemia: A Review and recommendations for management. J Cardiothorac Vasc Anesth 2014;28:1043-7.
DOI: https://doi.org/10.1053/j.jvca.2013.02.005
Erstad BL. Dapsone-induced methemoglobinemia and hemolytic anemia. Clin Pharm 1992;11:800-5.
How to Cite
Mauro, A., Parente, I., Gagliardo, T., Bonadies, A., Mancusi, R., Tipo, V., & Ponticiello, E. (2021). An acquired acute methemoglobinemia from dietary sources: Case reports and literature review. Emergency Care Journal, 17(1). https://doi.org/10.4081/ecj.2021.9089
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