Acute methemoglobinemia induced by dapsone / Metahemoglobinemia aguda induzida por dapsona: relato de caso no tratamento para hanseníase

Acute methemoglobinemia is an uncommon but potentially treatable disorder in witch patient can present with dramatic signs and symptoms. The early diagnostic and treatment are essentials to prevent this fatal medicine reaction.

Indexes of Suspicion of Typical Cow's Milk Protein-Induced Enterocolitis

This study was performed to identify clinical factors that facilitate the diagnosis of typical cow's milk protein-induced enterocolitis (CMPIE). Data from 142 consecutive patients (aged 15 to 45 days, cow's milk formula- or cow's milk and breast milk mixed-fed) admitted due to vomiting and/or diarrhea were retrospectively analyzed. These 142 subjects were divided into three groups: the CMPIE, infection, and non-infection group. Each group was composed of 16 (11.3%), 102 (71.8%), and 24 (16.9%) patients, respectively. On admission, poor weight gain (p=0.003), hypoalbuminemia (p=0.035), peripheral leukocytosis (p=0.012), and metabolic acidosis (p=0.015) were found to be more significant in the CMPIE group than those in other two groups. In CMPIE, serum albumin levels decreased from 3.3+/-0.9 g/dL on admission to 2.6+/-0.3 g/dL during admission (p<0.05), and methemoglobinemia was observed in 3 patients (18.8%) (p=0.012). Multiple logistic regression analysis showed that the independent predictors of CMPIE versus the infection group were failure to gain weight (OR, 10.75 [95% CI, 1.53-66.12]) (p= 0.014) and hypoalbuminemia (OR, 9.53 [95% CI, 1.62-49.01]) (p=0.010). The early recognition of indexes of suspicion for CMPIE may be of help in the diagnosis and treatment of this disorder.

Level of nitrate and nitrite contents in drinking water of selected samples received at AFPGMI, Rawalpindi

Contamination of drinking water by nitrates is an evolving public health concern since nitrate can undergo endogenous reduction to nitrite and nitrosation of nitrites can form N-nitroso compounds, which are potent carcinogens. The carcinogenic feature of N-nitroso compounds has been well established. Nitrites can lead among infants to the disease called methemoglobinemia [blue baby syndrome]. There is a strong relationship between nitrate concentration and recurrent diarrhoea and also other illnesses. The aim of this study was to evaluate the level of nitrate and nitrite contents in some drinking water samples. In this study we analysed 162 water samples received at Water Quality Control Laboratory, AFPGMI, Rawalpindi for their nitrate and nitrite contents. Out of these 162 water samples, 153 [94%] and 133 [82%] samples had nitrate and nitrite contents in varying concentrations, while 64 [40%] and 22 [14%] had nitrate and nitrite concentrations more than Pakistani standards. Given the potential health risk associated with the presence of toxicants like nitrates and nitrites in water sources used for drinking yet the scarcity of available data, there is a need to evaluate these waters and develop strategies to reduce and prevent their contamination

Congenital sulfhemoglobin and transient methemoglobinemia secondary to diarrhoea.

Sulfhemoglobinemia and Methemoglobinemia are common causes of cyanosis arising due to accumulation of abnormal heme pigment. We present an unusual case of congenital sulfhemoglobinemia along with diarrhoea induced methemo-globinemia in a neonate. A high index of suspicion and a proper diagnostic approach is needed to determine the true frequency of their occurrence together.

Metahemoglobinemia adquirida por intoxicación con dapsona: presentación de un caso / Acquired metahemglobinemia by dapsone intoxication

Presentamos un caso de Metahemoglobinemia adquirida por la ingesta de 40 comprimidos de Dapsona, con intención suicida, produciéndole a la paciente una cianosis periférica marcada y deterioro del sensorio; se realizó tratamiento con Azul de Metileno y Acido Ascórbico, registrándose cifras posterapéuticas de Metahemoglobinemia de 19 por ciento (valores normales hasta 2 por ciento). Teniendo buena respuesta clínica, con evolución favorable, sin secuelas posteriores

Acute cyanide poisoning: a case report with toxicokinetic study.

Cyanide poisoning is a life threatening condition. But specific antidotes exist and can be easily prepared from available substances in hospital. Administration of antidotes will produce methemoglobin, which itself causes hypoxia. Nitrite induced methemoglobin can be extremely dangerous and even lethal. Before administering the antidotes, the diagnosis should be confirmed. Nitrite should not be given if the poisoning is mild or diagnosis is uncertain, to avoid excessive methemoglobin, dosage of sodium nitrite must be adjusted according to hemoglobin level (Table 1). Usage of sodium nitrite and sodium thiosulfate in the recommended doses are safe and effective for cyanide poisoning.

Nitratos, nitritos e compostos N-nitrosos em alimentos: onde está o problema? / Nitrates, nitrites and N-nitrosocompounds in foods: where is the problem?

O objetivo deste artigo de revisäo é apresentar os problemas associados à presença de nitratos, nitritos e compostos. N-nitrosos em alimentos. Säo fornecidas informaçöes sobre as propriedades físico-químicas dos compostos, sua presença natural em vegetais e em alimentos processados, bem como os efeitos produzidos na exposiçäo humana: aspectos toxicológicos relacionados à ingestäo de nitratos e nitritos por adultos e crianças e á carcinogenicidade dos compostos N-nitrosos

Alteraçöes sanguíneas na populaçäo infantil de Cubatäo Säo Paulo, Brasil causadas pela exposiçäo a poluentes químicos do ambiente: carboxihemoglobinemia e metemoglobinemia / Serum changes in the infantile population in Cubatäo (Säo Paulo, Brasil) caused by the exposure to enviromental chemical pollutants: carboxyhemo-globinemia and methemoglobinemia

Para avaliar o grau de exposiçäo ao monóxido de carbono e aos agentes metemoglonizantes da populaçäo infantil do Município de Cubatäo (Säo Paulo, Brasil), procedeu-se a determinaçäo da porcentagem de carboxiemoglobina e metemoglina pelo método espectrofotométrico no sangue de criança na idade pré-escolar (4 a 5 anos) e matriculados nas Escolas Municipais de Educaçäo Infantil - EMEIs. Foram realizadas 251 determinaçöes de carboxiemoglobina e, entre 12 EMEIs, as médias variaram de 0,28% (na EMEI Estado de Goiás - Cubatäo-Centro) a 0.58% (na EMEI Estado de Säo Paulo - Cubatäo-Centro). Fez-se total de 270 determinaçöes de metemoglobina e a faixa de variaçäo das médias foi de 0,37% (na EMEI Rio de Janeiro - Vila Elizabeth) até 0,15% (na EMEI Estado do Ceará - Cubatäo-Centro)

Metahemoglobinemia en lactante pequeños / Methemoglobinemia in small infants

Se analizaron 40 casos consecutivos asistidos durante los dos últimos años, en el Hospital de Niños "Sor María Ludovica" de La Plata, que presentaron metahemoglobinemia (MHb). El 75% de los casos eran menores de 3 meses de vida. El motivo de consulta fueron manifestaciones gastrointestinales (diarrea, vómitos) en el 80% de los casos, cianosis en 17%, enfermedad respiratoria en el 12% y signos neurológicos en el 10%. Analizando los datos se vio que el 70% de los niños no tenían en sus hogares ningún servicio sanitario. El valor medio de MHb fue de 2,1 g/dl (rango 0,4-5,5 g/dl). Todos los niños, con excepción de uno, habían sido destetados. El 100% de los casos fue tratado exitosamente con vitamina C, como única medicación para su MHb