Department of Pediatrics, PGIMER, Dr RML Hospital, New Delhi, India.
J Trop Pediatr. 2012 Apr;58(2):154-6. doi: 10.1093/tropej/fmr042. Epub 2011 May 13.
A 16-year-old girl working in a paint and dye-casting factory of aniline dyes presented to the emergency with cyanosis, fever and altered sensorium. She had been diagnosed as a case of malaria and treated with chloroquine elsewhere. At admission, her saturation was 79%, which did not improve despite mechanical ventilation with 100% oxygen. Her PaO2 levels, however, remained high-140 mmHg. The observed difference in PaO2 and SpO2 prompted us to investigate her for methemoglobinemia, which was confirmatory. Despite symptomatic and specific treatment, she succumbed to her illness possibly due to late presentation and prolonged cerebral anoxia. Though the girl's raised methemoglobin levels may be explained by her history of exposure to aniline dyes, the temporal association of her methemoglobinemia related symptoms with chloroquine administration cannot be ignored. We believe that this rare complication of chloroquine therapy should be kept in mind before prescribing it to any child with malaria.
一名在苯胺染料涂料和铸造厂工作的 16 岁女孩因发绀、发热和意识改变到急诊就诊。她曾被诊断为疟疾，并在其他地方接受氯喹治疗。入院时，她的饱和度为 79%，尽管给予 100%氧气的机械通气，饱和度仍未改善。然而，她的 PaO2 水平仍保持在 140mmHg 左右。观察到 PaO2 和 SpO2 的差异促使我们对她进行高铁血红蛋白血症的检查，结果证实了这一点。尽管进行了对症和特效治疗，她还是因疾病而去世，可能是由于就诊晚和长时间的脑缺氧所致。虽然女孩高铁血红蛋白水平升高可能与她接触苯胺染料的病史有关，但不能忽视她与氯喹给药相关的高铁血红蛋白血症症状的时间关联。我们认为，在给任何患有疟疾的儿童开氯喹之前，都应该考虑到这种罕见的氯喹治疗并发症。
