E-Cigarettes and Methemoglobinemia: A Wolf in Sheep’s Clothing

Sahu, Kamal Kant; Lal, Amos; Mishra, Ajay Kumar; Sahu, Shamendra Anand

doi:10.1016/j.amjmed.2019.06.009

Cited by 13 publications

(6 citation statements)

References 3 publications

(3 reference statements)

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“…In situations where there is a temporal correlation between the onset of methaemoglobinaemia and cocaine use, it is crucial to investigate and exclude other simultaneous contributing factors [3]. Factors such as the use of e-cigarettes, consumption of water contaminated with nitrates/nitrites, intake of frozen items rich in nitrites/nitrates, certain foods like choy sum, herbal medications, topical and systemic dapsone used in antiacne treatments, as well as the utilization of over-the-counter medications like eutectic mixture of local anaesthetics (EMLA) cream, have been identified as associations with methaemoglobinaemia [6][7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Methaemoglobinaemia Associated With Mixed Cocaine and Amphetamine Overdose: A Case Report

Eshmandi,

Mohamed,

Khalil

et al. 2024

Cureus

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Methaemoglobinaemia is a rare disorder characterized by increased levels of methaemoglobin, a form of haemoglobin with oxidized iron that cannot efficiently bind oxygen. This leads to inadequate oxygen delivery to tissues with various clinical manifestations from asymptomatic to severe persistent hypoxia, CNS symptoms, and cardiovascular collapse. Acquired methaemoglobinaemia is typically a sudden condition, often resulting from poisoning by specific drugs and compounds, which can potentially have fatal consequences. We present a case of a patient who came with severe methaemoglobinaemia due to intoxication with cocaine and amphetamine.

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Section: Introductionmentioning

confidence: 99%

Methaemoglobinaemia Associated With Mixed Cocaine and Amphetamine Overdose: A Case Report

Eshmandi,

Mohamed,

Khalil

et al. 2024

Cureus

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“…Acquired methemoglobinemia is more common in infants and is most frequently caused by exposure to local anesthetics, dapsone, and nitrates or nitrites [3]. Less typically, but still importantly, methemoglobinemia can be caused by other common sources, including, e-cigarettes, cocaine or other 'street' drugs cut with benzocaine, inhalations of butyl nitrate 'poppers,' and ingestions of shoe dye or polish [4][5][6][7]. These substances act as oxidants and cause the reduction of hemoglobin to its methemoglobin form.…”

Section: Introductionmentioning

confidence: 99%

Phenazopyridine-Induced Methemoglobinemia: A Case Report

Koch¹,

Stolzenberg²,

Pathak³

et al. 2023

Cureus

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Methemoglobinemia is a condition caused by increased methemoglobin, a reduced form of hemoglobin, in the blood. This causes the molecules to bind oxygen more tightly and decreases their ability to release that oxygen to tissue. Most cases of methemoglobinemia are acquired and occur either in pediatric populations or in individuals with predisposing conditions. This report illustrates a case of an otherwise healthy 31-yearold patient presenting to the emergency department with cyanosis of the hands and mouth and an O2 saturation of 78% after taking increased doses of the over-the-counter medication phenazopyridine. A "chocolate-brown" color of her arterial blood, and increased methemoglobin levels of 20.2%, confirmed the diagnosis of methemoglobinemia. She was treated with both methylene blue and ascorbic acid, and her oxygen saturation and serum chemistry returned to normal levels within a few hours. The case highlights the importance of discussing the dosage of all over-the-counter medications with patients and recognizing the signs and symptoms of methemoglobinemia.

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“…Twohig et al recently reported a case of e-cig induced methemoglobinemia [9,10]. They found two E-liquid toxins vanillin and propylene glycol as the cause of methemoglobinemia in their case.…”

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confidence: 96%