Lava Lamp-Induced Methemoglobinemia in Dementia: A Case Report

Abstract

An elderly patient with progressive dementia presented with nonspecific symptoms of fatigue, skin discoloration, shortness of breath, and altered mental status. She quickly developed respiratory failure requiring emergent endotracheal intubation. Initial laboratory results revealed methemoglobinemia levels greater than 30% with blood appearing black in hue. The etiology of her acute symptoms and the inciting substance of the disease was an ongoing discussion with the patient's family, which ultimately revealed accidental ingestion of lava lamp fluid as the cause. Although rare, methemoglobinemia is a medical emergency requiring prompt diagnosis and treatment. When a thorough history fails to reveal a possible source, alternative origins should be investigated, such as household products.

Phenazopyridine-Induced Methemoglobinemia in a Jehovah’s Witness Treated with High-Dose Ascorbic Acid Due to Methylene Blue Contradictions: A Case Report and Review of the Literature

“…An alternative treatment is ascorbic acid, which can be utilized when MB is unavailable or contraindicated. There have been a few cases in the current literature detailing the use of ascorbic acid in cases of methemoglobinemia; these are listed in Table 1 [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. Up to 10 g can be administered in a single dose or in divided doses.…”

Ascorbic Acid for Methemoglobinemia Treatment: A Case Report and Literature Review

“…While methylene blue is the most reported treatment for methemoglobinemia, reports of using ascorbic acid as an alternative do exist and are described in more detail in Table 1. [6][7][8][9][10][11][12][13][14] Ascorbic acid is an antioxidant, which acts as a scavenger for free radicals and is thought to reduce methemoglobin back to the ferrous state (Fe 2+ ) which allows the iron to bind and release oxygen (Figure 2). 15,16 Previous reports have used ascorbic acid for this indication due to lack of availability of methylene blue or suspicion of/confirmed G6PD deficiency, however, dosing and efficacy remains variable.…”