[Methemoglobinemia due to ingestion of isobutyl nitrite ('poppers')].
Two male students, aged 20 and 21 years, developed central cyanosis shortly after drinking 5 ml of 'poppers' (isobutyl nitrite). They presented with methaemoglobinaemia and were hospitalised. After treatment with oxygen and intravenous fluids they could be discharged in good health the following day. Poppers are alkyl nitrites with vasdilative and oxidizing properties. They are used as party drugs (i.e. inhaled) because of their short-lived euphoric effect. Overdose can result in methaemoglobinaemia: the presence of oxidized haemoglobin which is unable to transport oxygen. Depending on the serum level of methaemoglobin this may result in central cyanosis, unconsciousness, coma and even death. Patients with high methaemoglobin levels should be treated with i.v. methylene blue.
Pruijm
M T C
MT
Leids Universitair Medisch Centrum, afd. Algemene Interne Geneeskunde, Postbus 9600, 2300 RC Leiden. m.pruijm@wanadoo.nl
de Meijer
P H E M
PH
D000328:Adult; D003490:Cyanosis / Q000139:chemically induced* / Q000628:therapy; D062787:Drug Overdose / Q000628:therapy; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005440:Fluid Therapy; D006801:Humans; D008297:Male; D008708:Methemoglobinemia / Q000139:chemically induced* / Q000628:therapy; D008751:Methylene Blue / Q000627:therapeutic use; D009573:Nitrites / Q000506:poisoning*; D010100:Oxygen / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000506:poisoning*
D004791:Enzyme Inhibitors; D009573:Nitrites; D014665:Vasodilator Agents; C018086:isobutyl nitrite; D010100:Oxygen; D008751:Methylene Blue