Changes in Incidence of Infantile Transient Methemoglobinemia Associated with Infectious Diarrhea during 1989-1999 in Kyungnam Province

ABSTRACT

PURPOSE: Infantile transient methemoglobinemia(ITM) may develop in association with infectious diarrhea without exposure to any toxic oxidizing agents. We observed that the number of ITM associated with infectious diarrhea have increased at the Gyeongsang National University Hospital (GNUH), located in the western area of Kyungnam province during the last 4 years. To determine whether this phenomenon was similarily observed in the rest of Kyungnam province, we studied the incidence of ITM associated with infectious diarrhea over the last 10 years in Kyungnam Provine. METHODS: All cases with ITM associated with infectious diarrhea were enrolled for this study from Ulsan Donggang Hospital(UDH), Masan Samsung Hospital(MSH), and GNUH over the last 10 years. Their medical records were reviewed retrospectively. RESULTS: Six and twelve cases were identified at UDH and GNUH, respectively, while none were identified at MSH. All the infants were less than 2 months of age and prosented with severe mucoid diarrhea with metabolic acidosis, high C-reactive protein(CRP) concentrations and/or leukocytosis with shift to left. Twelve cases were identified to reveal stool leukocytosis at UGH and GNUH. Eight cases had histories of ingestion of well water. Nine cases occurred in the spring season (May, April, March). Before 1996, a total of six cases occurred at UDH. But one case in 1990 and eleven cases occurred during 1996-99 at GNUH. The increase in the incidence of ITM associated with infectious diarrhea paralleled the increase in the infectious diarrhea in infants during 1996-99 at GNUH. CONCLUSION: The increased in the incidence of ITM associated with infectious diarrhea during the last4 years at GNUH was not observed in other parts of Kyungnam province. Infectious diarrhea, severe acidosis, severe dehydration, cow milk feeding, the spring season and ingestion of well water were considered to be important associateion factors of ITM.