Hemolytic anemia after methylene blue therapy for aniline-induced methemoglobinemia.
Methylene blue is utilized as the main treatment of methemoglobinemia conventionally, but it may be ineffective in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. We report a G6PD-deficient patient who suffered from aniline-induced methemoglobinemia with initial good response Heinz body but hemolytic anemia appeared later 3 d after methylene blue therapy. G6PD deficiency was identified. He recovered uneventfully with hydration, packed blood transfusion and adjuvant luvela-N(dl-alpha-tocopheryl nicotinate) medication. Caution should be taken in using methylene blue as antidote of acute methemoglobinemia, especially when a history of G6PD deficiency is obscure.
Liao
Yao-Pan
YP
Emergency Department, Taichung Veterans General Hospital, Taiwan.
Hung
Dong-Zong
DZ
Yang
Dar-Yu
DY
D000328:Adult; D000743:Anemia, Hemolytic / Q000139:chemically induced* / Q000503:physiopathology; D000814:Aniline Compounds / Q000506:poisoning*; D002273:Carcinogens; D004791:Enzyme Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D005955:Glucosephosphate Dehydrogenase Deficiency; D006801:Humans; D008297:Male; D008708:Methemoglobinemia / Q000139:chemically induced* / Q000188:drug therapy; D008751:Methylene Blue / Q000009:adverse effects* / Q000627:therapeutic use; D016273:Occupational Exposure
D000814:Aniline Compounds; D002273:Carcinogens; D004791:Enzyme Inhibitors; C023650:aniline; D008751:Methylene Blue