title: Central cyanosis on a psychiatric unit treated at the Salford Royal Hospital.
abstract: We describe a case of acquired methaemoglobinaemia due to frequent use of the 'legal high' known as 'Pink Panthers'. This contains 5,6-Methylenedioxy-2-aminoindane and 2-Aminoindane, both amphetamine analogues with the potential to cause methaemoglobinaemia. Furthermore, the most common 'cutting agent' for legal highs in the UK is benzocaine, also known to cause methaemoglobinaemia. Given the increasing prevalence of legal highs, particularly those containing added benzocaine, such presentations may become more common. Furthermore, in one case series, benzocaine gel used for toothache was the second most common reason for hospitalisation due to acquired methaemoglobinaemia after dapsone use. Indeed, the Federal Drug Agency has issued as public warning as to the risk of these products. We therefore think that clinicians and the public should be made more aware of the risk associated with such agents.
authors: Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK.
authors: Darren
authors: D
authors: Green
authors: North West Lung Centre, University Hospital of South Manchester, Manchester, UK.
authors: Peter
authors: P
authors: Barry
authors: North West Lung Centre, University Hospital of South Manchester, Manchester, UK.
authors: Heather D
authors: HD
authors: Green
mesh_terms: D001566:Benzocaine / Q000009:adverse effects; D003490:Cyanosis / Q000139:chemically induced*; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects; D007189:Indans / Q000009:adverse effects*; D008708:Methemoglobinemia / Q000139:chemically induced* / Q000175:diagnosis; D012565:Schizophrenic Psychology; D019966:Substance-Related Disorders / Q000150:complications* / Q000175:diagnosis
chemical_list: D013287:Illicit Drugs; D007189:Indans; C066678:5,6-methylenedioxy-2-aminoindane; C006545:2-aminoindan; D001566:Benzocaine
keywords: Clinical Epidemiology; Drug Reactions