Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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A Fatal Case of Methylene Blue Threatment Failure in Methemoglobinemia

메틸렌블루에 반응하지 않는 메트헤모글로빈혈증 1례

  • Shim, Ji-Yae (Medical College, Soonchunhyang University) ;
  • Seo, Yun-Seok (Department of Internal Medicine, Soonchunhyang University, Cheonan Hospital) ;
  • Yang, Jong-Oh (Department of Internal Medicine, Soonchunhyang University, Cheonan Hospital) ;
  • Lee, Eun-Young (Department of Internal Medicine, Soonchunhyang University, Cheonan Hospital) ;
  • Hong, Sae-Yong (Department of Internal Medicine, Soonchunhyang University, Cheonan Hospital) ;
  • Gil, Hyo-Wook (Department of Internal Medicine, Soonchunhyang University, Cheonan Hospital)
  • 심지예 (순천향대학교 의과대학) ;
  • 서연석 (순천향대학교 천안병원 내과) ;
  • 양종오 (순천향대학교 천안병원 내과) ;
  • 이은영 (순천향대학교 천안병원 내과) ;
  • 홍세용 (순천향대학교 천안병원 내과) ;
  • 길효욱 (순천향대학교 천안병원 내과)
  • Published : 2006.12.31
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Abstract

Acute toxic methemoglobinemia is an infrequent complication of the use of various drugs. Severe methemoglobinemia is very often fatal. Methylene blue is an effective drug in the treatment of methemoglobinemia patients. However, failure to respond to methylene blue has been described in patients with sulfhemoglobinemia, chlorate poisoning, and glucose-6-phosphate dehydrogenase deficiency. It is even possible that hemolysis may occur due to methylene blue treatment itself. We encountered a case of a 71-year-old woman who developed methemoglobinemia caused by alprazolam intoxication. She presented with hemolytic anemia and did not respond to methylene blue. In spite of concerted N-acetylcysteine therapy, the hemolytic anemia became aggravated and the patient died eleven days after intoxication.

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