The Drug-Induced Respiratory Disease Website
Known since the 1940s (PMID 18883450). Comprehensive list of causal drugs and chemicals available at PMID 1564446. Methemoglobin is the oxidized (Fe3+) species of hemoglobin (Fe2+). Patients present with slate-grey cyanosis, low SpO2, normal SaO2 and PaO2. Normally, methemoglobin is <1%. Levels above 40% can be life-threatening, producing pulmonary edema, cardiovascular collapse (PMID 17122537) CNS disturbances and death. Management includes i.v. methylene blue. A possible rebound increase in MeHb upon treatment requires close monitoring. Excess methylene blue can also produce methemoglobinemia. Guidelines: PMID 34467556.
Publications
Methemoglobinemia Secondary to a Traditional Healing Practice Using Mothballs: A Need of Pediatric Vigilance.
Cureus 2023 Jun;15;e41192 — 2023 Jun — e41192
Mothball Ingestion in the Setting of G6PD Deficiency Causing Severe Hemolytic Anemia, Methemoglobinemia, and Multiple Organ Failure in a Toddler.
Hawai'i journal of health & social welfare 2022 Jan;81;3-5 — 2022 Jan — 3-5
Kerosene, Camphor, and Naphthalene Poisoning in Children.
Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine 2019 Dec;23;S278-S281 — 2019 Dec — S278-S281
Naphthalene Toxicity in Clinical Practice.
Current drug metabolism 2019 Nov 21;; — 2019 Nov 21
Naphthalene Toxicity: Methemoglobinemia and Acute Intravascular Hemolysis.
Cureus 2018 Aug 15;10;e3147 — 2018 Aug 15 — e3147
Naphthalene ball poisoning: a rare cause of acquired methaemoglobinaemia.
BMJ case reports 2016 May 25;2016; — 2016 May 25