Methaemoglobinemia Induced by MDMA?

Case. A 45-year-old man with a blank medical history presented at the emergency room with dizziness and cyanosis. Physical examination showed cyanosis with a peripheral saturation (SpO2) of 85%, he did not respond to supplemental oxygen. Arterial blood gas analysis showed a striking chocolate brown...

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Main Author: L. L. W. Verhaert
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Case Reports in Pulmonology
Online Access:http://dx.doi.org/10.1155/2011/494328
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author L. L. W. Verhaert
author_facet L. L. W. Verhaert
author_sort L. L. W. Verhaert
collection DOAJ
description Case. A 45-year-old man with a blank medical history presented at the emergency room with dizziness and cyanosis. Physical examination showed cyanosis with a peripheral saturation (SpO2) of 85%, he did not respond to supplemental oxygen. Arterial blood gas analysis showed a striking chocolate brown colour. Based on these data, we determined the arterial methaemoglobin concentration. This was 32%. We gave 100% oxygen and observed the patient in a medium care unit. The next day, patient could be discharged in good condition. Further inquiry about exhibitions and extensive history revealed that the patient used MDMA (3,4- methylenedioxymethamphetamine, the active ingredient of ecstasy). Conclusion. Acquired methaemoglobinemia is a condition that occurs infrequently, but is potentially life threatening. Different nutrients, medications, and chemicals can induce methaemoglobinemia by oxidation of haemoglobin. The clinical presentation of a patient with methaemoglobinemia is due to the impossibility of O2 binding and transport, resulting in tissue hypoxia. Important is to think about methaemoglobin in a patient who presents with cyanosis, a peripheral saturation of 85% that fails to respond properly to the administration of O2. Because methaemoglobin can be reduced physiologically, it is usually sufficient to remove the causative agent, to give O2, and to observe the patient.
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spelling doaj-art-8f0a315ab7c347ec9d974429bd8678282025-02-03T05:46:25ZengWileyCase Reports in Pulmonology2090-68462090-68542011-01-01201110.1155/2011/494328494328Methaemoglobinemia Induced by MDMA?L. L. W. Verhaert0Catharina Hospital Eindhoven, The NetherlandsCase. A 45-year-old man with a blank medical history presented at the emergency room with dizziness and cyanosis. Physical examination showed cyanosis with a peripheral saturation (SpO2) of 85%, he did not respond to supplemental oxygen. Arterial blood gas analysis showed a striking chocolate brown colour. Based on these data, we determined the arterial methaemoglobin concentration. This was 32%. We gave 100% oxygen and observed the patient in a medium care unit. The next day, patient could be discharged in good condition. Further inquiry about exhibitions and extensive history revealed that the patient used MDMA (3,4- methylenedioxymethamphetamine, the active ingredient of ecstasy). Conclusion. Acquired methaemoglobinemia is a condition that occurs infrequently, but is potentially life threatening. Different nutrients, medications, and chemicals can induce methaemoglobinemia by oxidation of haemoglobin. The clinical presentation of a patient with methaemoglobinemia is due to the impossibility of O2 binding and transport, resulting in tissue hypoxia. Important is to think about methaemoglobin in a patient who presents with cyanosis, a peripheral saturation of 85% that fails to respond properly to the administration of O2. Because methaemoglobin can be reduced physiologically, it is usually sufficient to remove the causative agent, to give O2, and to observe the patient.http://dx.doi.org/10.1155/2011/494328
spellingShingle L. L. W. Verhaert
Methaemoglobinemia Induced by MDMA?
Case Reports in Pulmonology
title Methaemoglobinemia Induced by MDMA?
title_full Methaemoglobinemia Induced by MDMA?
title_fullStr Methaemoglobinemia Induced by MDMA?
title_full_unstemmed Methaemoglobinemia Induced by MDMA?
title_short Methaemoglobinemia Induced by MDMA?
title_sort methaemoglobinemia induced by mdma
url http://dx.doi.org/10.1155/2011/494328
work_keys_str_mv AT llwverhaert methaemoglobinemiainducedbymdma