Eating vegetables is not always a good advice. A case report and literature review of acquired methemoglobinemia
Methemoglobinemia (MET) is a life-threatening condition resulting from the development of methemoglobin (MetHb), which binds oxygen irreversibly, causing refractory hypoxia and so-called “functional anemia”. MET can be caused by hereditary or acquired processes. Acquired forms are the most common. S...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2024-01-01
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| Series: | Emergency Care Journal |
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| Online Access: | https://www.pagepressjournals.org/index.php/ecj/article/view/12034 |
| _version_ | 1797342291877167104 |
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| author | Andrea Vercelli Irene Nasone Laura Pagani Alessandro Dacrema Alberto Veneziani Antonio Agosti Erika Poggiali |
| author_facet | Andrea Vercelli Irene Nasone Laura Pagani Alessandro Dacrema Alberto Veneziani Antonio Agosti Erika Poggiali |
| author_sort | Andrea Vercelli |
| collection | DOAJ |
| description | Methemoglobinemia (MET) is a life-threatening condition resulting from the development of methemoglobin (MetHb), which binds oxygen irreversibly, causing refractory hypoxia and so-called “functional anemia”. MET can be caused by hereditary or acquired processes. Acquired forms are the most common. Symptoms correlate with the MetHb level and range from cyanosis and dyspnea to dysrhythmias, metabolic acidosis, coma, and cardiac arrest. MetHb levels above 70% are fatal. Methylene blue (MB) is the specific antidote. In all cases, supportive treatment, including intravenous hydration, glucose correction, and oxygen supplementation, must be started immediately. Exchange transfusion has been used successfully to treat MET and may be appropriate in patients for whom MB is ineffective. We report the case of a 54-year-old woman who presented to our emergency department for the acute and sudden development of chest pain, shortness of breath, and severe cyanosis after drinking a significant amount of boiled courgette water. Arterial blood gas analysis revealed a MetHb level of 26%. She was treated immediately with MB, oxygen supplementation, and hydration with normalization of her MetHb in 12 hours. Our recommendation is to always investigate MET in patients with unexplained cyanosis and refractory hypoxia.
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| first_indexed | 2024-03-08T10:31:10Z |
| format | Article |
| id | doaj.art-2b229b4bdd0f494aada52c9ae3969a91 |
| institution | Directory Open Access Journal |
| issn | 2282-2054 |
| language | English |
| last_indexed | 2024-03-08T10:31:10Z |
| publishDate | 2024-01-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Emergency Care Journal |
| spelling | doaj.art-2b229b4bdd0f494aada52c9ae3969a912024-01-26T23:09:51ZengPAGEPress PublicationsEmergency Care Journal2282-20542024-01-0110.4081/ecj.2024.12034Eating vegetables is not always a good advice. A case report and literature review of acquired methemoglobinemiaAndrea Vercelli0Irene Nasone1Laura Pagani2Alessandro Dacrema3Alberto Veneziani4Antonio Agosti5Erika Poggiali6Emergency Department, Guglielmo da Saliceto Hospital, PiacenzaDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan; Emergency Department, IRCCS Humanitas Research Hospital, Rozzano, MilanEmergency Department, Guglielmo da Saliceto Hospital, PiacenzaEmergency Department, Guglielmo da Saliceto Hospital, PiacenzaEmergency Department, Guglielmo da Saliceto Hospital, PiacenzaEmergency Department, Guglielmo da Saliceto Hospital, PiacenzaEmergency Department, Guglielmo da Saliceto Hospital, PiacenzaMethemoglobinemia (MET) is a life-threatening condition resulting from the development of methemoglobin (MetHb), which binds oxygen irreversibly, causing refractory hypoxia and so-called “functional anemia”. MET can be caused by hereditary or acquired processes. Acquired forms are the most common. Symptoms correlate with the MetHb level and range from cyanosis and dyspnea to dysrhythmias, metabolic acidosis, coma, and cardiac arrest. MetHb levels above 70% are fatal. Methylene blue (MB) is the specific antidote. In all cases, supportive treatment, including intravenous hydration, glucose correction, and oxygen supplementation, must be started immediately. Exchange transfusion has been used successfully to treat MET and may be appropriate in patients for whom MB is ineffective. We report the case of a 54-year-old woman who presented to our emergency department for the acute and sudden development of chest pain, shortness of breath, and severe cyanosis after drinking a significant amount of boiled courgette water. Arterial blood gas analysis revealed a MetHb level of 26%. She was treated immediately with MB, oxygen supplementation, and hydration with normalization of her MetHb in 12 hours. Our recommendation is to always investigate MET in patients with unexplained cyanosis and refractory hypoxia. https://www.pagepressjournals.org/index.php/ecj/article/view/12034Methemoglobinemiamethemoglobinmethylene bluecyanosishypoxiacourgette |
| spellingShingle | Andrea Vercelli Irene Nasone Laura Pagani Alessandro Dacrema Alberto Veneziani Antonio Agosti Erika Poggiali Eating vegetables is not always a good advice. A case report and literature review of acquired methemoglobinemia Emergency Care Journal Methemoglobinemia methemoglobin methylene blue cyanosis hypoxia courgette |
| title | Eating vegetables is not always a good advice. A case report and literature review of acquired methemoglobinemia |
| title_full | Eating vegetables is not always a good advice. A case report and literature review of acquired methemoglobinemia |
| title_fullStr | Eating vegetables is not always a good advice. A case report and literature review of acquired methemoglobinemia |
| title_full_unstemmed | Eating vegetables is not always a good advice. A case report and literature review of acquired methemoglobinemia |
| title_short | Eating vegetables is not always a good advice. A case report and literature review of acquired methemoglobinemia |
| title_sort | eating vegetables is not always a good advice a case report and literature review of acquired methemoglobinemia |
| topic | Methemoglobinemia methemoglobin methylene blue cyanosis hypoxia courgette |
| url | https://www.pagepressjournals.org/index.php/ecj/article/view/12034 |
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