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Successful Treatment of Nitrobenzene Poisoning with Oral Methylene Blue and Ascorbic Acid in a Resource Limited Setting
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Nitrobenzene as a weedicide is rarely being consumed as a means of suicide. Its combination with an organophosphorus compound poses additional dilemma in the diagnosis and treatment if the culprit poisons can not be identified accurately. The matter gets complicated in a resource poor setting in a developing country where even ideal medications are not available. A 55 year old male with a suicidal consumption of a cocktail of unknown substance was saved by alert diagnosis of methemoglobinemia followed by treatment with the laboratory preparation of locally available oral methylene blue and high dose oral ascorbic acid. The unnecessary need for the mechanical ventilation was judiciously avoided even in the setting of a persistently low pulse oximetry readings.
Keywords
Ascorbic Acid, Methemoglobinemia, Methylene Blue, Nitrobenzene.
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- Agency for Toxic Substances and Disease Registry (ATSDR). Toxicological Profile for Nitrobenzene. U.S. Department of Health and Human Services, Public Health Service. Atlanta, GA; 1990.
- Skold Anna, Dominique L, Cosco MD, Robin Klein MD. Methemoglobinemia:pathogenesis, diagnosis, and management. South Med J November2011;104(11):757-61.
- G. R. Honig, “Hemoglobin disorder,” in Nelson Textbook of Pediatrics, R. E. Behrman, R. M. Kleigman, and H. B. Jenson, Eds., pp. 1478–1488, Saunders, Philadelphia, Pa, USA, 2000.
- Dutta R, Dube SK, Mishra LD, Singh AP. Acute methemoglobinemia. Internet J Emerg Intensive Care Med 2008; 11:1092-4051.
- Gupta G, Poddar B, Salaria M, Parmar V. Acute Nitrobenzene Poisoning. Indian Pediatrics. 2000; 37:1147-8.
- Wright RO, Lewander WJ, Woolf AD. Methemoglobinemia: Etiology, Pharmacology, and clinical management. Ann Emerg Med. 1999;34:646–56. [PubMed: 10533013]
- Martinez MA, Ballesteros S, Almarza E, Sanchez de la Torre C, Bua S. Acute Nitrobenzene Poisoning with Severe Associated Methemoglobinemia: Identification in Whole Blood by GC–FID and GC–MS. Journal of Analytical Toxicology. 2003; 27(4):221-5.
- Hoffman RS, Nelson SL, Howland MA, Lewin NA, Flomenbaum NE, Goldfrank LR, editors. New York: McGraw Hill Medical; 2007. Goldfrank’s Manual of toxicological emergencies.
- Whitwan JG, Taylor AR, White JM. Potential hazard of methylene blue. Anaesthesia 1979; 34:181182.
- Park SY, Lee KW, Kang TS. High-dose vitamin C management in dapsone-induced methemoglobinemia. Am J Emerg Med 2014; 32:684.e1.
- Rino PB, Scolnik D, Fustinana A, et al. Ascorbic acid for the treatment methemoglobinemia: the experience of a large tertiary care pediatric hospital. Am J Ther 2014; 21:240
- Coleman MD, Rhodes LE, Scott AK, et al. the use of cimetidine to reduce dapsone-dependent methemoglobinemia in dermatitis herpetiformis patients. Br J ClinPharmacol 1992; 34:244.
- J. Dotsch, S. Demirakca, M. Kratz, R. Repp, I. Knerr, and W. Rascher,“Comparison of methylene blue, riboflavin, and N-acetylcysteine for the reduction of nitric oxide-induced methemoglobinemia,” Critical Care Medicine, vol. 28, no. 4, pp.958–961, 2000.
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