title: Ascorbic acid for the treatment of methemoglobinemia: the experience of a large tertiary care pediatric hospital.
abstract: The purpose of reporting this series of patients is to illustrate the role of ascorbic acid in the treatment of severe acquired methemoglobinemia (metHb), especially when methylene blue is not available. Medical records of affected patients were reviewed to collect history of exposures, food ingestion, physical examination, pulse oximetry, blood gas, and co-oximetry results, and outcomes. Five cases of acquired metHb are presented here, all of whom received treatment with ascorbic acid and fully recovered after 24 hours of treatment. Our series emphasizes that ascorbic acid is an effective alternative in the management of acquired metHb if methylene blue is unavailable and suggests that ascorbic acid infusion may be indicated in patients with glucose-6-phosphatase dehydrogenase deficiency.
authors.affiliation: 1Division of Pediatric Emergency Medicine, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina; 2Division of Pediatric Emergency Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Ontario, Canada; 3Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, University of Toronto, Ontario, Canada; 4Division of Pediatric Emergency Medicine, Department of Pediatrics, Dana-Dwek Children Hospital, University of Tel Aviv, Tel Aviv, Israel; and 5Division of Clinical Pharmacology and Toxicology, Ichilov Hospital, University of Tel Aviv, Tel Aviv, Israel.
authors.forename: Pedro Bonifacio
authors.initials: PB
authors.lastname: Rino
authors.forename: Dennis
authors.initials: D
authors.lastname: Scolnik
authors.forename: Ana
authors.initials: A
authors.lastname: Fustiñana
authors.forename: Alexis
authors.initials: A
authors.lastname: Mitelpunkt
authors.forename: Miguel
authors.initials: M
authors.lastname: Glatstein
mesh_terms: D000975:Antioxidants / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use*; D002675:Child, Preschool; D005260:Female; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000150:complications; D006801:Humans; D007223:Infant; D008297:Male; D008708:Methemoglobinemia / Q000188:drug therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000975:Antioxidants; D001205:Ascorbic Acid