Blue Treatment for Blue Patient: Toxicology
Journal of Clinical Toxicology has recently published an article entitled “Blue Treatment for Blue Patient” in its previous issue Volume 9 | Issue 4. Authors Dipanjan Halder, Kishen Goel and Praveen Aggarwal has submitted the article and the article was well written.
Article explains about the Cyanosis is a clinical sign indicates lack of tissue oxygenation due to various causes. Methemoglobinemia is one of those causes due to oxidation of iron moiety of haem in haemoglobin, making it a lesser oxygen carrier to tissue.
Abstract of the article is as follows Cyanosis is a clinical sign indicates lack of tissue oxygenation due to various causes. Methemoglobinemia is one of those causes due to oxidation of iron moiety of haem in haemoglobin, making it a lesser oxygen carrier to tissue. Various drugs, gases and substances can produce oxidative stress upon a genetically predisposed or a normal individual, converting haemoglobin to methaemoglobin and cause varying degree of cyanosis. Prompt identification and proper antidote can save patient’s life and decreases need for unnecessary invasive ventilatory support and complications.
This is a case-report of 27-year-old male was brought to Emergency Department with altered sensorium, cyanosis and 2 episodes of vomiting. His relatives gave a history of unknown substance intake few hours back. He was found lying on the floor in his room and vomit by the side. He was immediately shifted to the hospital.
Methaemoglobin is an abnormal form of haemoglobin where iron moiety present in a “Haem” is oxidized [Ferrous (Fe2+) to Ferric (Fe3+) iron] and oxygen carrying capacity is reduced several times than the normal one. In our body there is constant transformation of methaemoglobin to haemoglobin by enzyme NADH cytochrome b5 reductase. Individuals who are genetically deficient of NADH cytochrome b5 reductase or sometimes toxic exposure to substances like aniline, nitrobenzene, nitrite pesticides in normal individual can cause methemoglobinemia.
Finally the conclusion is about Methemoglobinemia is not an uncommon presentation in emergency, clinical features and positive correlation with history of exposure to culprit agents sometimes easily clenches the diagnosis. But where history is unknown, clinicians should make a suspicion of methemoglobinemia and subsequent blood tests and prompt diagnosis with treatment by proper antidote can reduce chances of complications and unnecessary use of mechanical ventilatory support.
For more details about the case report please go through the below link:
Journal of Clinical Toxicology
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