Aniline-induced refractory methemoglobinemia in polytrauma: successful management with erythrocytapheresis

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00843989%3A_____%2F25%3AE0111993" target="_blank" >RIV/00843989:_____/25:E0111993 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216224:14110/25:00143780 RIV/61988987:17110/25:A2603D7V

Výsledek na webu

<a href="https://doi.org/10.1186/s12245-025-01026-8" target="_blank" >https://doi.org/10.1186/s12245-025-01026-8</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1186/s12245-025-01026-8" target="_blank" >10.1186/s12245-025-01026-8</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Aniline-induced refractory methemoglobinemia in polytrauma: successful management with erythrocytapheresis

Popis výsledku v původním jazyce

Background: Methemoglobinemia is a life-threatening condition characterized by the inability of hemoglobin to transport oxygen efficiently. This case report describes acquired methemoglobinemia caused by exposure to aniline dye, which was successfully treated with erythrocytapheresis following the insufficient effect of methylene blue. Case presentation: A 39-year-old male suffered multiple injuries, including burns and fractures, after falling into a barrel containing aniline. On site, emergency medical services (EMS) intubated the patient, performed chest decompression for pneumothorax, and decontaminated him before transferring him to a trauma centre. In the emergency unit, imaging revealed multiple rib, scapula, and pelvic fractures, retroperitoneal bleeding, and 15% total body surface area (TBS) burns. He was hemodynamically unstable, with metabolic acidosis, an oxygen saturation gap, and an initial methemoglobin level (MetHb) of 19%. Despite methylene blue treatment, the MetHb levels rose to undetectable levels (> 20%), and severe hemodynamic instability, refractory hypoxia, and metabolic derangement required the use of erythrocytapheresis. Conclusion: Aniline exposure leads to the oxidation of ferrous iron (Fe2 +) in hemoglobin to ferric iron (Fe3 +), resulting in methemoglobinemia and impaired oxygen delivery. While methylene blue remains the first-line treatment, erythrocytapheresis proved effective in restoring tissue oxygenation in refractory methemoglobinemia complicated by hemorrhagic and traumatic shock.

Název v anglickém jazyce

Aniline-induced refractory methemoglobinemia in polytrauma: successful management with erythrocytapheresis

Popis výsledku anglicky

Background: Methemoglobinemia is a life-threatening condition characterized by the inability of hemoglobin to transport oxygen efficiently. This case report describes acquired methemoglobinemia caused by exposure to aniline dye, which was successfully treated with erythrocytapheresis following the insufficient effect of methylene blue. Case presentation: A 39-year-old male suffered multiple injuries, including burns and fractures, after falling into a barrel containing aniline. On site, emergency medical services (EMS) intubated the patient, performed chest decompression for pneumothorax, and decontaminated him before transferring him to a trauma centre. In the emergency unit, imaging revealed multiple rib, scapula, and pelvic fractures, retroperitoneal bleeding, and 15% total body surface area (TBS) burns. He was hemodynamically unstable, with metabolic acidosis, an oxygen saturation gap, and an initial methemoglobin level (MetHb) of 19%. Despite methylene blue treatment, the MetHb levels rose to undetectable levels (> 20%), and severe hemodynamic instability, refractory hypoxia, and metabolic derangement required the use of erythrocytapheresis. Conclusion: Aniline exposure leads to the oxidation of ferrous iron (Fe2 +) in hemoglobin to ferric iron (Fe3 +), resulting in methemoglobinemia and impaired oxygen delivery. While methylene blue remains the first-line treatment, erythrocytapheresis proved effective in restoring tissue oxygenation in refractory methemoglobinemia complicated by hemorrhagic and traumatic shock.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30221 - Critical care medicine and Emergency medicine

Projekt

—

Návaznosti

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

International journal of emergency medicine

ISSN

1865-1372

e-ISSN

1865-1380

Svazek periodika

18

Číslo periodika v rámci svazku

article 232

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

4

Strana od-do

1-4

Kód UT WoS článku

001609743400001

EID výsledku v databázi Scopus

2-s2.0-105021034807