Abstract
A case is reported of methaemoglobinaemia presenting with recurrent fits in the absence of cyanosis. A low oxygen saturation measured on pulse oximetry that fails to improve with oxygen treatment, the presence of "chocolate brown" blood that does not change on exposure to air, and a high PaO2 arterial blood gas with oxygen therapy should support such a diagnosis. A diagnostic blood methaemoglobin level should be obtained.
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Selected References
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- Baker S. A., Young D. J. Methemoglobinemia: the hidden diagnosis. Crit Care Nurse. 1990 Mar;10(3):50–53. [PubMed] [Google Scholar]
- Caudill L., Walbridge J., Kuhn G. Methemoglobinemia as a cause of coma. Ann Emerg Med. 1990 Jun;19(6):677–679. doi: 10.1016/s0196-0644(05)82476-x. [DOI] [PubMed] [Google Scholar]
- Dolan M. A., Luban N. L. Methemoglobinemia in two children: disparate etiology and treatment. Pediatr Emerg Care. 1987 Sep;3(3):171–175. doi: 10.1097/00006565-198709000-00011. [DOI] [PubMed] [Google Scholar]
- Edwards R. J., Ujma J. Extreme methaemoglobinaemia secondary to recreational use of amyl nitrite. J Accid Emerg Med. 1995 Jun;12(2):138–142. doi: 10.1136/emj.12.2.138. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Eisenkraft J. B. Pulse oximeter desaturation due to methemoglobinemia. Anesthesiology. 1988 Feb;68(2):279–282. doi: 10.1097/00000542-198802000-00018. [DOI] [PubMed] [Google Scholar]
- Forsyth R. J., Moulden A. Methaemoglobinaemia after ingestion of amyl nitrite. Arch Dis Child. 1991 Jan;66(1):152–152. doi: 10.1136/adc.66.1.152. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gowans W. J. Fatal methaemoglobinaemia in a dental nurse. A case of sodium nitrite poisoning. Br J Gen Pract. 1990 Nov;40(340):470–471. [PMC free article] [PubMed] [Google Scholar]
- Hoffman R. S., Sauter D. Methemoglobinemia resulting from smoke inhalation. Vet Hum Toxicol. 1989 Apr;31(2):168–170. [PubMed] [Google Scholar]
- Johnson C. J., Bonrud P. A., Dosch T. L., Kilness A. W., Senger K. A., Busch D. C., Meyer M. R. Fatal outcome of methemoglobinemia in an infant. JAMA. 1987 May 22;257(20):2796–2797. [PubMed] [Google Scholar]
- Kellett P. B., Copeland C. S. Methemoglobinemia associated with benzocaine-containing lubricant. Anesthesiology. 1983 Nov;59(5):463–464. doi: 10.1097/00000542-198311000-00019. [DOI] [PubMed] [Google Scholar]
- Mansouri A., Lurie A. A. Concise review: methemoglobinemia. Am J Hematol. 1993 Jan;42(1):7–12. doi: 10.1002/ajh.2830420104. [DOI] [PubMed] [Google Scholar]
- Sandza J. G., Jr, Roberts R. W., Shaw R. C., Connors J. P. Symptomatic methemoglobinemia with a commonly used topical anesthetic, cetacaine. Ann Thorac Surg. 1980 Aug;30(2):187–190. doi: 10.1016/s0003-4975(10)61240-4. [DOI] [PubMed] [Google Scholar]
- Shesser R., Dixon D., Allen Y., Mitchell J., Edelstein S. Fatal methemoglobinemia from butyl nitrite ingestion. Ann Intern Med. 1980 Jan;92(1):131–132. doi: 10.7326/0003-4819-92-1-131_2. [DOI] [PubMed] [Google Scholar]