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KMID : 1013220170150020148
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Jouranl of the Korean Society of Clinical Toxicology
2017 Volume.15 No. 2 p.148 ~ p.151
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A Case of a Herbicide Poisoning Induced Methemoglobinemia Patient Treated with High-dose Vitamin C
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Sun Kyeong-Hoon
Kim Jun-Kew
Ryu Chang-Yeon
Kim Seo-Jin
Jo Hyeon-Kyu
Yoo Tae-Ho
Park Yong-Jin
Kim Sun-Pyo
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Abstract
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Methemoglobinemia is a condition in which the iron portion of hemoglobin, which binds to oxygen, is oxidized to produce methemoglobin, which increases blood concentration. There are many causes, the most common are food, drugs, and chemicals. A 75-year-old male patient who had taken herbicide did not notice any nonspecific symptoms. After 4 hours, methemoglobin increased to 17.1%. and after 7 hours, it increased to 26.5%, and intravenous administration of methylene blue 1mg / kg, an antidote, started. After a total of 5 doses of methylene blue 1 mg / kg due to reactive methemoglobinemia for about 36 hours, methemoglobin increased to 23.7%. Methylene blue could not be used additionally, 10 g of ascorbic acid(Vitamin C)was intravenously administered as an antidote. After 82 hours, ascorbic acid 10g was given six times for repeated reactive methemoglobinemia. No additional reactive methemoglobinemia was observed. After the follow up, the patient successfully escaped the ventilator and the endotracheal tube on the 5th day of admission.
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KEYWORD
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Methemoglobinemia, Methylene blue, Ascorbic acid
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