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BMC Genomics 2018 Dec 5;19(1):877. Epub 2018 Dec 5.

U.S. Army Public Health Center, Aberdeen Proving Ground, Aberdeen, MD, 21010, USA.

Background: The health and resilience of species in natural environments is increasingly challenged by complex anthropogenic stressor combinations including climate change, habitat encroachment, and chemical contamination. To better understand impacts of these stressors we examined the individual- and combined-stressor impacts of malaria infection, food limitation, and 2,4,6-trinitrotoluene (TNT) exposures on gene expression in livers of Western fence lizards (WFL, Sceloporus occidentalis) using custom WFL transcriptome-based microarrays.

Results: Computational analysis including annotation enrichment and correlation analysis identified putative functional mechanisms linking transcript expression and toxicological phenotypes. Read More

Can Vet J 2018 Nov;59(11):1216-1222

Department of Emergency and Critical Care, VCA West Los Angeles Animal Hospital, Los Angeles, California, USA.

An 8-year-old, spayed female Chihuahua mixed breed dog was presented for dyspnea and was subsequently mechanically ventilated. Propofol was utilized as part of the anesthetic protocol. The dog developed rhabdomyolysis, myoglobinuria, cardiac arrhythmias, liver enzyme elevation, and methemoglobinemia. Read More

Ir Med J 2018 03 14;111(3):718. Epub 2018 Mar 14.

Paediatric Infectious Disease Department, Children's University Hospital, Temple Street, Dublin 1.

An increase in invasive group A streptococcus (GAS) cases referred to the paediatric infectious disease (PID) department of the Children's University Hospital (CUH), Temple Street, prompted review of all invasive GAS cases in 2016. All of the 10 cases identified occurred over a 16-week period from February to June, of which 6 (60%) required admission to the paediatric intensive care unit. The median length of stay was 21. Read More

Case Rep Crit Care 2018 25;2018:8198565. Epub 2018 Sep 25.

The D'Or Institute for Research & Education (IDOR), Rio de Janeiro, Brazil.

Deficiency of glucose-6-phosphate dehydrogenase (G6PD) is the commonest enzyme deficiency in humans with a wide range of possible clinical manifestations depending on the specific genetic variant in each case. Here we present the case of an 86-year-old male of African descent who acutely developed symptoms of G6PD deficiency immediately after he received methylene blue for treating methemoglobinemia. The contrast between a low SO on pulse oximetry and a normal arterial gas sampling raised the possibility of methemoglobinemia. Read More

Wien Med Wochenschr 2018 Oct 22. Epub 2018 Oct 22.

Center of Physical and Rehabilitative Medicine, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany.

Methemoglobinemia is characterized by an increased level of methemoglobin (MetHb) in the peripheral blood. MetHb levels increase after tumescent anesthesia and need to be monitored. If a patient becomes symptomatic and/or the MetHb levels increase >10%, intravenous injection of an antidote is recommended. Read More

Cureus 2018 Aug 15;10(8):e3147. Epub 2018 Aug 15.

Internal Medicine, University of Maryland Prince George's Hospital Center, Cheverly, USA.

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. Read More

AJP Rep 2018 Oct 15;8(4):e227-e229. Epub 2018 Oct 15.

MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, United Kingdom.

Methemoglobinemia can result in severe hypoxia. It has been frequently reported during the use of inhaled nitric oxide, but can occur where nitrate containing medications are used. Glyceryl trinitrate (GTN) patches have been used in the treatment of digital and limb ischemia in prematurely born infants. Read More

Cureus 2018 Aug 1;10(8):e3084. Epub 2018 Aug 1.

Critical Care, St Luke's Health System, Kansas City, USA.

We present a rare case of rasburicase-induced methemoglobinemia and hemolytic anemia in the setting of presumed glucose-6-phosphate dehydrogenase (G6PD) deficiency. A 78-year-old male with a known history of chronic lymphocytic leukemia presented to the clinic with fever of unknown origin. Laboratory results were significant for hyperuricemia. Read More

J Clin Med 2018 Oct 10;7(10). Epub 2018 Oct 10.

Centro Andaluz de Biología del Desarrollo, Departamento de Anatomía, Fisiología y Biología Celular, Universidad Pablo de Olavide-CSIC, 41013 Sevilla, Spain.

Cytochrome b5 reductase 3 (CYB5R3) is a membrane-bound NADH-dependent redox enzyme anchored to the mitochondrial outer membrane, endoplasmic reticulum, and plasma membrane. Recessive hereditary methaemoglobinaemia (RHM) type II is caused by CYB5R3 deficiency and is an incurable disease characterized by severe encephalopathy with mental retardation, microcephaly, generalized dystonia, and movement disorders. Currently, the etiology of type II RHM is poorly understood and there is no treatment for encephalopathy associated with this disease. Read More

Indian J Crit Care Med 2018 Sep;22(9):670-673

Institute of Critical Care Medicine, Max Super Speciality Hospital, New Delhi, India.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an x-linked recessive genetic disorder with mutation in the G6PD gene. Defect in the enzyme G6PD causes red blood cells (RBCs) to breakdown prematurely causing hemolytic anemia. Hemolytic anemia is also a known hematological complication associated with viral hepatitis. Read More

Forensic Sci Med Pathol 2018 Oct 6. Epub 2018 Oct 6.

Institute of Forensic Medicine, University of Belgrade - School of Medicine, 31a Deligradska str, Belgrade, 11000, Serbia.

Sodium nitrite is used as a coloring agent or preservative in food, as well as an antimicrobial agent in meat and fish and some cheeses. In high amounts it can be toxic for humans, causing methemoglobinemia. This is an unusual and potentially fatal condition in which hemoglobin is oxidized to methemoglobin (MHb), reducing the amount of oxygen that is released from hemoglobin, similar to carbon monoxide poisoning. Read More

Clin Exp Emerg Med 2018 Sep 30;5(3):192-198. Epub 2018 Sep 30.

Institute of Health Sciences, Gyeongsang National University, Jinju, Korea.

Objective: Dapsone (diaminodiphenyl sulfone, DDS) is currently used to treat leprosy, malaria, dermatitis herpetiformis, and other diseases. It is also used to treat pneumocystis pneumonia and Toxoplasma gondii infection in HIV-positive patients. The most common adverse effect of DDS is methemoglobinemia from oxidative stress. Read More

Comp Biochem Physiol C Toxicol Pharmacol 2019 Jan 27;215:18-24. Epub 2018 Sep 27.

Institute of Biology, University of Leiden, Leiden 2300 RA, the Netherlands.

While it has been known for a while that some snake species are extremely sensitive to acetaminophen, the underlying mechanism for this toxicity has not been reported. To investigate if essential detoxification enzymes are missing in snake species that are responsible for biotransformation of acetaminophen in other vertebrate species, livers were collected from a variety of snake species, together with samples from alligator, snapping turtle, cat, rat, and cattle. Subcellular fractions were analyzed for enzymatic activities of phenol-type sulfotransferase and UDP‑glucuronosyltransferase, total glutathione S‑transferase, and N‑acetyltransferase. Read More

Dermatol Online J 2018 Jul 15;24(7). Epub 2018 Jul 15.

Naval Medical Center, San Diego, California.

Linear IgA bullous dermatosis is a rare bullous disease in children and adults that can be associated with autoimmune conditions, malignancies, infections, or medication exposure. The definitive diagnosis relies on the biopsy. A 58-year-old man presented to our clinic with a pruritic vesicular and bullous eruption. Read More

Ecotoxicol Environ Saf 2018 Dec 20;166:48-55. Epub 2018 Sep 20.

Laboratorio de Biología Celular y Molecular, Facultad de Ciencias Químicas, Universidad Juárez del Estado de Durango, Av. Artículo 123 s/n Fracc. Filadelfia, C.P. 35010 Gómez Palacio, Durango, Mexico. Electronic address:

Nitrate pollution has emerged as a problem of great importance because in recent years, the levels of nitrate in soil and groundwater have increased, mainly through anthropogenic activities, such as the use of fertilizers in agriculture, domestic wastewater and septic tanks, industrial waste and deforestation. In animals, nitrate reduction to nitrite (NO) and nitric oxide (NO) promote the formation of methemoglobin in the blood and the generation of highly reactive intermediates that induce oxidative stress in target organs. Exposition to nitrates has been associated with methemoglobinemia, reproductive toxicity, metabolic and endocrine alterations and cancer. Read More

J Forensic Sci 2018 Sep 19. Epub 2018 Sep 19.

Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA.

Ochronosis is the blue-gray discoloration of collagen-containing tissues due to homogentisic acid (HGA) deposition, secondary to endogenous alkaptonuria or exogenous enzyme inhibition. In renal disease, accumulation of HGA in serum can cause methemoglobinemia. A 60-year-old woman with renal disease and anemia presented with 3 days of weakness and months of gray skin discoloration. Read More

Data Brief 2018 Aug 2;19:2133-2138. Epub 2018 Jul 2.

Department of Environmental Health Engineering, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

Bottled water is one of the sources of drinking water in many arid and semi-arid countries, including Iran. The greatest concern is the health effects of exposure to excessive nitrate concentrations in drinking water due to the development of methemoglobinemia in children. Therefore, the present study was aimed at determining the concentration of nitrate and its risk assessment in drinking water bottled in Iran. Read More

Pharmacogenomics J 2018 Sep 12. Epub 2018 Sep 12.

Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA.

Phenotypic rather than genotypic tests remain the gold standard for diagnosing glucose-6-phosphate dehydrogenase (G6PD) deficiency. However, with increasing use of genomic arrays and whole exome or genome sequencing, G6PD genetic data are increasingly available. We examined the utility of G6PD genetic data in patients with hematologic malignancies and the association of G6PD genotype and phenotype with rasburicase-induced methemoglobinemia. Read More

Data Brief 2018 Oct 13;20:394-401. Epub 2018 Aug 13.

Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Nitrate is a groundwater pollutant which in higher concentrations limits, leads to health hazard such as Methemoglobinemia and formation of nitrosamine compounds. In this research, the nitrate and nitrite concentrations in all water resources in the villages of Songor plain were determined and the relationship between these values with the water table and zonation of nitrate concentration were investigated in the GIS environment. In this study, 37 samples of all groundwater resources of Sonqor plain were taken in, high water (March 2016) and low water (October 2017) periods. Read More

J Crit Care 2018 Dec 18;48:63-65. Epub 2018 Aug 18.

Section of Pediatric Cardiac Intensive Care, Riley Hospital for Children at Indiana University Health, 705 Riley Hospital Drive, Indianapolis, IN, USA; Department of Pediatrics, Indiana University School of Medicine, 340 W. 10th St. #6200, Indianapolis, IN, USA.

Purpose: Inhaled nitric oxide (iNO) has been associated with safety risks including reports of methemoglobinemia. While standard of care recommends routine monitoring of methemoglobin in subjects on iNO therapy, the utility of this practice remains unknown.

Materials And Methods: This retrospective chart review aimed to determine the frequency of methemoglobinemia in pediatric patients receiving iNO. Read More

Food Chem Toxicol 2018 Oct 19;120:709-723. Epub 2018 Aug 19.

ToxStrategies, Newport, KY, USA.

Dietary nitrate has been associated with health benefits as well as potential risks, thus presenting a paradox for consumers and health professionals. To address the issue, we applied the Benefit-Risk Analysis for Foods (BRAFO) framework to evaluate dietary exposure to nitrate by considering how the risks and benefits might vary under the reference scenario of the acceptable daily intake (ADI) set forth by JECFA (3.7 mg/kg-day), or under an alternative scenario of a higher ADI (independently developed herein). Read More

Am J Respir Crit Care Med 2018 Aug 16. Epub 2018 Aug 16.

Groupe hospitalier Lariboisiere Fernand-Widal, 26934, Paris, France ;

Wiad Lek 2018;71(4):839-842

Higher State Educational Institution Of Ukraine, Ukrainian Medical Stomatological Academy, Poltava, Ukraine.

Objective: Introduction: The topicality is determined bypriority and importance of researches that have preventive referral directed on provision of harmonious growth and early childhood development, children's resistance to the infection's effects and other unfavorable external factors. There are problems about the role of permanent nitrate load in the formation of children health issues, especially children who live in the area with high nitrate levels in drinking well water. The aim is to evaluate the physical development of children who live in nitrate-contaminated areas. Read More

Clin Pract Cases Emerg Med 2018 Aug 16;2(3):207-210. Epub 2018 Jul 16.

Duke University, Department of Emergency Medicine, Durham, North Carolina.

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. Read More

Am J Ind Med 2018 Jul 27. Epub 2018 Jul 27.

Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.

We report a Korean worker who experienced dermal exposure to a hot copper sulfate solution at his workplace and developed severe acute copper sulfate poisoning. A 53-year-old male worker, who was employed in a lead smelter for 5 years, slipped, and his right lower leg entered a copper sulfate solution, leading to severe burns of the right lower leg. Two days later, he developed severe intravascular hemolysis with methemoglobinemia. Read More

A A Pract 2018 Jul 25. Epub 2018 Jul 25.

Department of Intensive Care Medicine.

We present a case of a 73-year-old cancer patient with low transcutaneous oxygen saturation who was transferred to the intensive care unit after deployment of the rapid response team. Differential diagnosis remained broad until methemoglobinemia (MetHb) was detected. MetHb was induced by administration of rasburicase, which was given to prevent tumor lysis syndrome. Read More

Int J Environ Res Public Health 2018 07 23;15(7). Epub 2018 Jul 23.

Department of Toxicogenomics, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, P.O Box 616, 6200 MD Maastricht, The Netherlands.

Nitrate levels in our water resources have increased in many areas of the world largely due to applications of inorganic fertilizer and animal manure in agricultural areas. The regulatory limit for nitrate in public drinking water supplies was set to protect against infant methemoglobinemia, but other health effects were not considered. Risk of specific cancers and birth defects may be increased when nitrate is ingested under conditions that increase formation of -nitroso compounds. Read More

Toxicol In Vitro 2018 Oct 18;52:286-296. Epub 2018 Jul 18.

DOS in Biochemistry, University of Mysore, Manasagangothri, Mysuru 570 006, India; Department of Studies and Research in Biochemistry, Tumkur University, Tumakuru 572103, India. Electronic address:

Exposure of human population to industrial chemicals is believed as a significant contributing factor to the outgrowth of occupational diseases especially in developing countries due to improper safety measures and sanitary conditions. Para-tertiary butylcatechol (PTBC) widely employed in petrochemical, thermofax and phototypesetting industries, induces melanocytotoxicity and contact dermatitis leading to occupational leukoderma/vitiligo. Few vitiligo patients were reported for oxidative stress-induced hemolytic anemia and thrombocytopenia, however its impact on blood components is still not clear. Read More

Arch Argent Pediatr 2018 Aug;116(4):e612-e615

Hospital Zonal de Agudos "Magdalena V. de Martínez", Pacheco, Buenos Aires.

Methemoglobinemia is a condition characterized by a high blood concentration of methemoglobin. Methemoglobinemia is a disorder that occurs when hemoglobin in the blood is oxidized to form methemoglobin, rendering it unable to transport oxygen. Although it can be congenital in cyanotic newborn, it is more often an adverse medication effect. Read More

Biomed Opt Express 2018 Jul 25;9(7):3284-3305. Epub 2018 Jun 25.

Natural Phenomena Simulation Group, D. R. Cheriton School of Computer Science, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada.

Methemoglobinemia and sulfhemoglobinemia are potentially life-threatening blood-related disorders characterized by similar symptoms and markedly distinct treatment procedures. In this paper, we investigate the causal relationship between these conditions and the onset of cyanosis, which is typically associated with a purple or bluish skin coloration. More specifically, we perform controlled experiments to elicit cyanotic appearances resulting from different severity levels of these disorders and varying physiological conditions. Read More

Indian J Anaesth 2018 Jun;62(6):475-476

Department of Internal Medicine, Chennai Medical College Hospital and Research Center, Trichy, Tamil Nadu, India.

J Ayub Med Coll Abbottabad 2018 Apr-Jun;30(2):301-303

Pennine Acute Hospitals NHS Trust, United Kingdom.

A 51-year-old male was referred to the diabetes clinic by the GP with low HbA1c (13 mmol/mol). His complaints were dizziness and intermittent palpitations for the last two years. No precipitating cause could be identified. Read More

Cureus 2018 Apr 20;10(4):e2513. Epub 2018 Apr 20.

Department of Pediatrics, Herbert Wertheim College of Medicine Florida International University, Miami, USA.

We report a child who was on immunosuppressive therapy for renal transplant rejection, with end-stage renal disease, and who developed methemoglobinemia while receiving dapsone for Pneumocystis jiroveci infection prophylaxis. Read More

Am J Ther 2018 Nov/Dec;25(6):e771-e772

Department of Medicine, Pulmonary and Critical Care, State University of New York Upstate Medical University Syracuse, NY.

Clin Case Rep 2018 Jun 17;6(6):1077-1081. Epub 2018 Apr 17.

Section of Anesthesiology and Clinical Physiology Division of Oral Health Sciences Department of Oral Restitution Graduate School Tokyo Medical and Dental University Tokyo Japan.

During intravenous sedation, a decrease in SpO2 is usually the result of respiratory failure. However, we experienced a case with SpO2 decrease that was caused by methemoglobinemia in prilocaine infiltration anesthesia during sedation. This indicates that methemoglobinemia should be considered if low SpO2 is sustained unrelated to sedation level. Read More

Data Brief 2018 Apr 2;17:431-437. Epub 2018 Feb 2.

Students Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

In recent years, contamination of water resources, with pollutants such as nitrate and nitrite, has significantly increased. These compounds can have harmful effects on human health, especially children such as methemoglobinemia. The main objective of this study was to measure the concentration of nitrate and nitrite and its health-risk assessment in the rivers entering Taham dam in Zanjan. Read More

Case Rep Crit Care 2018 30;2018:1903787. Epub 2018 Apr 30.

Division of Pediatric Critical Care, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.

A 5-week-old previously healthy male presented with vomiting and diarrhea leading to hypovolemic shock and profound metabolic acidosis. He was subsequently found to have severe methemoglobinemia. The acidosis and shock improved with fluid resuscitation and methemoglobinemia was successfully treated with methylene blue. Read More

Neth J Med 2018 May;76(4):194-197

Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

A 61-year-old Ghanaian woman presented with dizziness and low oxygen saturations whereupon a methaemoglobin level of 24.9% was obtained. Initially it was thought to be caused by an unknown toxin. Read More

Med Pr 2018 May 10;69(3):345-350. Epub 2018 May 10.

Warszawski Uniwersytet Medyczny / Medical University of Warsaw, Warszawa, Poland (Zakład Ratownictwa Medycznego / Department of Emergency Medical Services).

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. Read More

Int J Legal Med 2018 May 21. Epub 2018 May 21.

Centre antipoison et de toxicovigilance de Paris, hôpital Fernand-Widal, Paris, France.

Background: Eutectic mixtures of lidocaine and prilocaine are used during painful dermatological procedures. Poisoning is rarely reported in adults.

Material And Method: We report three cases of women who experienced lidocaine and prilocaine poisoning after laser-assisted hair removal. Read More

Indian J Pediatr 2018 10 18;85(10):929-930. Epub 2018 May 18.

Institute of Child Health, Kolkata, India.

Arch Argent Pediatr 2018 06;116(3):e429-e432

Sala 3.ª de Internación de Clínica Pediátrica del Hospital de Niños Superiora Sor María Ludovica, La Plata, Buenos Aires.

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. Read More

Turk J Surg 2018 1;34(1):74-76. Epub 2018 Mar 1.

Department of Anesthesiology and Reanimation, Ege University School of Medicine, İzmir, Turkey.

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. Read More

PLoS One 2018 8;13(5):e0196716. Epub 2018 May 8.

Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.

Introduction: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzymopathy in the human population affecting an estimated 8% of the world population, especially those living in areas of past and present malaria endemicity. Decreased G6PD enzymatic activity is associated with drug-induced hemolysis and increased risk of severe neonatal hyperbilirubinemia leading to brain damage. The G6PD gene is on the X chromosome therefore mutations cause enzymatic deficiency in hemizygote males and homozygote females while the majority of heterozygous females have an intermediate activity (between 30-80% of normal) with a large distribution into the range of deficiency and normality. Read More

Environ Sci Pollut Res Int 2018 May 7. Epub 2018 May 7.

Urology and Nephrology Center, Mansoura University, Mansoura, 35516, Egypt.

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. Read More

Hematol Rep 2018 Mar 2;10(1):7221. Epub 2018 Mar 2.

Department of Hematology and Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.

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. Read More

Med Klin Intensivmed Notfmed 2018 Apr 17. Epub 2018 Apr 17.

Klinik für Innere Medizin und Internistische Intensivmedizin, St.-Antonius-Hospital, Dechant-Deckers-Str. 8, 52249, Eschweiler, Deutschland.

Background: This case report presents a case of symptomatic methemoglobinemia (MetHb 31.6%) after inhalation of volatile nitrites (poppers).

Methods: The patient's medical history and symptoms are discussed together with pathophysiology of methemoglobinemia, diagnostics, and antidote therapy. Read More

Acute Med Surg 2018 04 15;5(2):199-201. Epub 2018 Feb 15.

Department of Emergency and Disaster Medicine Gifu University Graduate School of Medicine Gifu Japan.

Case: Methylene blue is useful for the treatment of methemoglobinemia. However, even after the patient's methemoglobin (metHb) rate has improved, careful observation is important because they could have undiagnosed congenital methemoglobinemia. In this case, a 67-year-old man underwent gastrointestinal endoscopy with the use of lidocaine for local anesthesia. Read More