Bristol Ian, Brown Jubilee, Slomovitz Brian M, Shannon Vickie R, Eifel Patricia J
Department of Radiation Oncology, Unit 97, U.T. M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
Gynecol Oncol. 2005 Jun;97(3):953-6. doi: 10.1016/j.ygyno.2005.03.015.
Methemoglobinemia is a rare disorder most commonly associated with the ingestion or topical application of an offending exogenous agent. The clinical consequences of acute methemoglobinemia can be devastating and include lethargy, headache, and dyspnea and, as methemoglobin concentrations rise, respiratory depression, confusion, seizures, and even death.
Here we present a case of acute methemoglobinemia induced by exposure to topical vaginal sulfanilamide cream in a 36-year-old woman with a FIGO stage IIIB squamous cell cervical carcinoma.
Although methemoglobinemia associated with topical anesthetics has been well documented, to our knowledge this is the first reported case of methemoglobinemia induced by exposure to topical sulfanilamide cream. Although patients undergoing intracavitary radiation treatment for cervical cancer are at risk for cyanosis due to the development of deep vein thromboses and pulmonary embolism, methemoglobinemia should be suspected in the setting of acute cyanosis with a normal arterial oxygen pressure.
高铁血红蛋白血症是一种罕见疾病，最常与摄入或局部应用有害的外源性物质相关。急性高铁血红蛋白血症的临床后果可能是毁灭性的，包括嗜睡、头痛、呼吸困难，并且随着高铁血红蛋白浓度升高，会出现呼吸抑制、意识模糊、癫痫发作甚至死亡。
在此，我们报告一例36岁国际妇产科联盟（FIGO）IIIB期宫颈鳞状细胞癌女性因局部应用阴道磺胺乳膏而诱发急性高铁血红蛋白血症的病例。
虽然与局部麻醉剂相关的高铁血红蛋白血症已有充分记录，但据我们所知，这是首例因接触局部磺胺乳膏诱发高铁血红蛋白血症的报告病例。尽管接受宫颈癌腔内放射治疗的患者因深静脉血栓形成和肺栓塞的发生而有发绀风险，但在动脉血氧压力正常的急性发绀情况下应怀疑高铁血红蛋白血症。
