Methemoglobinemia as a result of accidental lacquer thinner poisoning

Singh, Ranju; Vinayagam, Stalin; Vajifdar, Homay

doi:10.4103/0972-5229.94435

Cited by 19 publications

(13 citation statements)

References 13 publications

(17 reference statements)

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“…Once it is absorbed, nitrobenzene is metabolized into nitrosobenzene, which is toxic and causes methemoglobinemia [ 1 , 14 , 20 ]. According to international and domestic studies on nitrobenzene addiction, most exposure takes place via ingestion and absorption through the skin [ 13 - 15 , 21 - 23 ].…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Methemoglobinemia Induced by the Exposure to Nitrobenzene and Aniline

Lee

Kim

Kwon

et al. 2013

Ann of Occup and Environ Med

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ObjectiveTo report two cases of methemoglobinemia induced by inhaled nitrobenzene and dermally absorbed aniline.MethodsWe have evaluated a 37-year-old male worker exposed to nitrobenzene by inhalation while conducting maintenance job of mononitrobenzene pump and a 25-year-old male worker exposed dermally to aniline while unloading.ResultsThe first case is a 37-year-old male exposed to nitrobenzene. His blood methemoglobin concentration level was initially 19.8%, and chest X-ray was normal. After oxygen therapy, the blood methemoglobin concentration level decreased to 2.1%, and the symptoms were alleviated. The second case is a 25-year-old male exposed dermally to aniline. His chest X-ray was normal, but blood methemoglobin concentration level reached maximally 46.8%. He was treated with methylene blue due to relatively high blood methemoglobin level. Gradually after the treatment, his methemoglobin concentration level was normalized to 0.8% and simultaneously symptoms were resolved.ConclusionsAfter the thorough exposure investigations and medical evaluations, we have concluded that these cases were methemoglobinemia induced by occupational exposure to nitrobenzene and aniline. We suggest that businesses which handle methemoglobinemia-causing substances control the engineering process strictly, implement periodic screening, and establish emergency patient management system.

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Section: Discussionmentioning

confidence: 99%

Two Cases of Methemoglobinemia Induced by the Exposure to Nitrobenzene and Aniline

Lee

Kim

Kwon

et al. 2013

Ann of Occup and Environ Med

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“…Our search yielded 365 citations (Figure ), of which 25 fulfilled our inclusion criteria (27 subjects) . Studies that mentioned exchange transfusion in the management of methaemoglobinemia, but failed to provide the details, were also not included .…”

Section: Systematic Reviewmentioning

confidence: 99%

“…Median methaemoglobin concentration was 37.5% (range 3.7% to 81%), while in one subject the level was out of the detectable range . Methaemoglobin was measured using CO‐oximetry in the majority (n = 24, 75%), followed by absorption spectrophotometry (n = 4) . Of the 16 subjects in whom G‐6‐PD levels were reported, 6 (37.5%) were G‐6‐PD deficient …”

Section: Systematic Reviewmentioning

confidence: 99%

Therapeutic whole blood exchange in the management of methaemoglobinemia: Case series and systematic review of literature

Singh

Kodati

Agarwal

et al. 2020

Transfusion Medicine

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Background Therapeutic whole blood exchange (TWBE) has been used as an alternative when methylene blue (MB) fails in severe methaemoglobinemia. However, there are limited data on the efficacy and safety of TWBE. Objectives Our aim was to report our institutional experience with TWBE. We also perform a systematic review of published literature. Methods We retrospectively reviewed our respiratory intensive care unit database to identify cases of methaemoglobinemia managed with TWBE. A systematic review of the PubMed database was performed to identify similar cases (≥12 years). We report the indications, utility, and safety of therapeutic exchange in methaemoglobinemia. The procedural details were also noted. Results We identified five subjects who received TWBE for methaemoglobinemia (median methaemoglobin level 39%; range 19.6‐42.4%). TWBE was successful in all five cases and no adverse events were encountered. Our review identified 27 additional subjects. The median methaemoglobin level was 37.5% (range 3.7‐81%). The most common indication (n = 24, 75%) for therapeutic exchange was a lack of response to MB. A majority of the subjects (n = 26/32, 81.2%) survived. No procedure‐related complications were reported. Conclusion TWBE is a safe and effective salvage modality for adults with methaemoglobinemia, when MB is either contraindicated or ineffective. Future studies should standardise therapeutic exchange in the management of methaemoglobinemia.

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“…Paint thinner is a chemical mixture of different aromatic and halogenated hydrocarbons (e.g., toluene, benzene, xylene and N-hexane), commonly used in various industrial applications as solvent in removing household paints and thinning oil-based paint (Solak et al, 2006 ; Verma and Gomber, 2009 ; Singh et al, 2012 ; Agin et al, 2016 ). Despite its usefulness, there is increasing concern about occupational exposure of industrial workers to this solvent (Yilmaz et al, 2001 ).…”

Section: Introductionmentioning

confidence: 99%

Prenatal Exposure to Paint Thinner Alters Postnatal Development and Behavior in Mice

Malloul

Mahdani

Bennis

et al. 2017

Front. Behav. Neurosci.

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Occupational exposure and sniffing of volatile organic solvents continue to be a worldwide health problem, raising the risk for teratogenic sequelae of maternal inhalant abuse. Real life exposures usually involve simultaneous exposures to multiple solvents, and almost all the abused solvents contain a mixture of two or more different volatile compounds. However, several studies examined the teratogenicity due to industrial exposure to a single volatile solvent but investigating the teratogenic potential of complex chemical mixture such as thinner remains unexplored. This study was undertaken to evaluate developmental neurotoxicity of paint thinner using a mouse model. Mated female mice (N = 21) were, therefore, exposed to repeated and brief inhalation episodes of 0, 300 or 600 ppm of thinner during the entire period of pregnancy. Females weigh was recorded and their standard fertility and reproductive parameters were assessed. After birth postnatal day 1 (PND1), offspring (N = 88) length and body weight were measured in a daily basis. At PND5, the pups were assessed for their postnatal growth, physical maturation, reflex development, neuromotor abilities, sensory function, activity level, anxiety, depression, learning and memory functions. At adulthood, structural changes of the hippocampus were examined by estimating the total volume of the dentate gyrus. Except one case of thinner induced abortion at the higher dose, our results showed that the prenatal exposure to the solvent did not cause any maternal toxicity or decrease in the viability of the offspring. Therefore, a lower birth weight, decrease in the litter size and delayed reflexes ontogeny were registered in prenatally exposed offspring to both 300 ppm and 600 ppm of thinner. In addition, prenatally exposure to thinner resulted in increased anxiolytic-and depression-like behaviors. In contrast, impaired learning and memory functions and decreased hippocampal dentate gyrus volume were revealed only in the prenatally treated offspring by 600 ppm of thinner. Based on these results, we can conclude that prenatally exposure to paint thinner causes a long-lasting developmental neurotoxicity and alters a wide range of behavioral functions in mice. This shows the risk that mothers who abuse thinner paint expose their offspring.

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Methemoglobinemia as a result of accidental lacquer thinner poisoning

Cited by 19 publications

References 13 publications

Two Cases of Methemoglobinemia Induced by the Exposure to Nitrobenzene and Aniline

Two Cases of Methemoglobinemia Induced by the Exposure to Nitrobenzene and Aniline

Therapeutic whole blood exchange in the management of methaemoglobinemia: Case series and systematic review of literature

Prenatal Exposure to Paint Thinner Alters Postnatal Development and Behavior in Mice

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