Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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A Case of a Herbicide Poisoning Induced Methemoglobinemia Patient Treated with High-dose Vitamin C

제초제 중독으로 유발된 메트헤모글로빈혈증 환자에서 고용량 비타민 C 치료 1례

  • Sun, Kyung Hoon (Department of Emergency Medicine, Chosun University Hospital) ;
  • Kim, Jun Kew (Department of Emergency Medicine, Chosun University Hospital) ;
  • Ryu, Chang Yeon (Department of Emergency Medicine, Chosun University Hospital) ;
  • Kim, Seo Jin (Department of Emergency Medicine, Chosun University Hospital) ;
  • Jo, Hyeon Kyu (Department of Emergency Medicine, Chosun University Hospital) ;
  • Yoo, Tae Ho (Department of Emergency Medicine, Chosun University Hospital) ;
  • Park, Yong Jin (Department of Emergency Medicine, Chosun University Hospital) ;
  • Kim, Sun pyo (Department of Emergency Medicine, Chosun University Hospital)
  • 선경훈 (조선대학교 의과대학 응급의학교실) ;
  • 김준규 (조선대학교 의과대학 응급의학교실) ;
  • 류창연 (조선대학교 의과대학 응급의학교실) ;
  • 김서진 (조선대학교 의과대학 응급의학교실) ;
  • 조현규 (조선대학교 의과대학 응급의학교실) ;
  • 유태호 (조선대학교 의과대학 응급의학교실) ;
  • 박용진 (조선대학교 의과대학 응급의학교실) ;
  • 김선표 (조선대학교 의과대학 응급의학교실)
  • Received : 2017.07.30
  • Accepted : 2017.10.08
  • Published : 2017.12.31
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Abstract

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 of methemoglobinemia, the most common being food, drugs, and chemicals. A 75-year-old male patient who had taken an herbicide did not notice any nonspecific symptoms. However, after 4 hours, his methemoglobin levels increased to 17.1%, while after 7 hours it increased to 26.5%, at which time intravenous administration of methylene blue 1 mg/kg (an antidote) was started. After a total of five doses of methylene blue at 1 mg/kg due to reactive methemoglobinemia for about 36 hours, the methemoglobin levels increased to 23.7%. Because no more methylene blue could be administered, 10 g of ascorbic acid (vitamin C) was administered intravenously. After 82 hours, ascorbic acid 10 g was administered six times for repeated reactive methemoglobinemia. No additional reactive methemoglobinemia was observed. The ventilator and endotracheal tube were successfully removed on day 5 after admission.

Keywords

References

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