title: Coincidental Finding of Beta Thalassaemia Minor in a Patient of Lacquer Thinner Poisoning Presenting as Methaemoglobinemia.
abstract: Lacquer thinner, commonly used for removing household paints, is known to contain various aromatic hydrocarbons and naphtha; if ingested, may cause methaemoglobinemia. We report a case of 13-year-old girl who presented with episodes of vomiting, abdominal pain and numbness of limbs. Peripheral blood smear showed few fragmented erythrocytes and 10-12 nucleated red blood cells /100 white blood cells. Reticulocyte count was 15% with presence of Heinz bodies. There was a history of accidental ingestion of lacquer paint thinner. Levels of methaemoglobin were very high along with raised HbA2 levels. An impression of haemolytic anaemia, due to lacquer thinner paint poisoning, with methaemoglobinemia was given. Incidentally High Performance Liquid Chromatography (HPLC) revealed increased HbA2 levels i.e., heterozygous inheritance of beta thalassaemia minor. Patient responded well to methylene blue. Blood transfusion was performed and symptomatic treatment was given.
authors.affiliation: Presently-Assistant Professor, Department of Pathology, ESIC Medical College and Hospital , Faridabad, Haryana; Formerly-Senior Resident, Department of Pathology, PGIMER Dr RML Hospital, New Delhi, India .
authors.forename: Charu
authors.initials: C
authors.lastname: Agarwal
authors.affiliation: Senior Resident, Department of Pathology, PGIMER Dr RML Hospital , New Delhi, India .
authors.forename: Anisha
authors.initials: A
authors.lastname: Mohanpuria
authors.affiliation: Professor, Department of Pathology, PGIMER Dr RML Hospital , New Delhi, India .
authors.forename: Gurdeep
authors.initials: G
authors.lastname: Buxi
authors.affiliation: Associate Professor, Department of Pathology, PGIMER Dr RML Hospital , New Delhi, India .
authors.forename: Vijay
authors.initials: V
authors.lastname: Kumar
keywords: Haemolytic Anaemia; Heinz bodies; Heterozygous inheritance