Management of Herbicide Induced Methemoglobinemia

Abstract

Methemoglobinemia is an altered state of haemoglobin that leads to impaired oxygen delivery to the body tissues. Deliberate ingestion of certain herbicides may lead to this condition. Modern herbicides are often synthetic mimics of natural plant hormones that interfere with growth of the target plants. These modern herbicides act by various mechanisms some of them being Acetyl co-enzyme A carboxylase inhibition, aceto lactate synthase inhibition, photosystem II inhibition, 4-hydroxy phenyl pyruvate dioxygenase inhibition and so on. We report a case of Methemoglobinemia after deliberate ingestion of an herbicide marketed to be safe and containing only biological extracts and filters. The patient was treated with ascorbic acid successfully. Our paper emphasizes the use of ascorbic acid as an alternative method in the treatment of Methemoglobinemia. Ascorbic acid is the main stay of treatment in patients with G6PD deficiency.

Herbicide poisoning assocaited methhemoglobinemia as a cause of hypoxia — approach & emergency management — A case report

“…1 Usual pattern of signs & symptoms are cyanosis, low O2 saturation, normal PaO2 (arterial oxygen in ABG) 1 it is found that there is mismatch & disparity between measured Spo2 & PaO2 without any presence of evolving cardiac & respiratory system abnormality which makes to think about suspicion of Methhemoglobinemia. 2 Patient has headache, nausea, vomiting, cynoderma in early stage of toxemia. 1 There is altered mental sensorium progressing to drowsiness, seizures, coma & death in later stages of critical illness.…”

“…1 Insecticides containing biological extract are rich in nitrogenous products, stabilizers & fillers. Methylene blue is treatment of choice in patients other than G6PD deficiency, 2 Ascorbic acid is main stay of treatment in G6PD deficient individuals as methylene blue precipitate hemolysis in these group. 2 Various diagnostic methods include O2 saturation gap (CO-OXIMETRY), 3 multiple wavelength spectrophotometry, 3 filter paper test, 3 potassium cyanide test.…”

“…Methylene blue is treatment of choice in patients other than G6PD deficiency, 2 Ascorbic acid is main stay of treatment in G6PD deficient individuals as methylene blue precipitate hemolysis in these group. 2 Various diagnostic methods include O2 saturation gap (CO-OXIMETRY), 3 multiple wavelength spectrophotometry, 3 filter paper test, 3 potassium cyanide test. 3 Two forms of Methhemoglobinemia one is congenital a rare one, another more common acquired.…”

“…1 As physiology says it results into shifting of OXYGEN DISSOCIATION CURVE to left. 2 G6Pd level measurement is necessary in case with Methhemoglobinemia. Two forms of Methhemoglobinemia one is congenital a rare one, another more common acquired.…”

“…Two forms of Methhemoglobinemia one is congenital a rare one, another more common acquired. [2][3][4]…”