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. 2012 May;12(2):237-41.
doi: 10.12816/0003120. Epub 2012 Apr 9.

Acquired methemoglobinaemia

Adil Al-Lawati  1 , Nick Murch
Affiliations

Acquired methemoglobinaemia

Adil Al-Lawati et al. Sultan Qaboos Univ Med J. 2012 May.

Abstract

Acquired methemoglobinaemia is a relatively rare condition and, therefore infrequently encountered in acute medical practice. Suspicion of the condition may be triggered when the measured PaO2 is 'out of keeping' with the oxygen saturations that are discovered with pulse oximetry. We describe two separate cases of acquired methemoglobinaemia secondary to the recreational use of alkyl nitrites ('poppers'). The patients presented at separate times to two different teaching hospitals in London, UK. The similarity of these cases has led the authors to conclude that a raised awareness of this potentially fatal condition, and its association with a widely-available recreational drug, is necessary to ensure a correct and timely diagnosis.

Keywords: Case report; Methaemoglobinaemia; Methylene blue; UK.

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Figures

Figure 1:
Figure 1:
Bottle of alkyl nitrite provided by Patient 2
Figure 2:
Figure 2:
The role of methylene blue in the treatment of methaemoglobinemia Legend: G6P = glucose 6 phosphate; G-6-PD = glucose-6-phosphate dehydrogenase; R5P = ribose-5-phosphate; NADP = nicotine adenine dinucleotide phosphate; NADPH = nicotine adenine dinucleotide phosphate hydrogenase; MetHb = methaemaglobin; Hb = haemoglobin
See this image and copyright information in PMC

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