Article Text

Reminder of important clinical lesson
Acute methaemoglobinaemia after massive nitrobenzene ingestion
  1. Mark Perera,
  2. Fatima Shihana,
  3. Keerthi Kularathne,
  4. Damika Dissanayake,
  5. Andrew Dawson
  1. SACTRC, Peradeniya, Peradeniya, 091, Sri Lanka
  1. Mark Perera, mark{at}sactrc.org

Summary

Flower-N is a flowering stimulant composition with 22% nitrobenzene. The main systemic effect associated with human exposure to nitrobenzene is methaemoglobinaemia. A 25-year-old female presented after 3 hours following ingestion of 100 ml of 22% Nitrobenzene (Flower-N). Her initial methaemoglobin (MetHb) was 81%; this responded to methylene blue. However, she developed recurrent methaemoglobinaemia on days 3 and 5 with haemolytic anaemia. The treatments that were provided were repeated methylene blue treatment and exchange transfusion. Nitrobenzene ingestion is a known cause of methaemoglobinaemia and haemolytic anaemia. The recurrence suggests a long half-life. The recurrent MetHb has clinical implications as patients may require repeated treatment. Massive nitrobenzene ingestion can cause haemolysis and recurrent methaemoglobinaemia.

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Footnotes

  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication.