Kaczorowska-Hac Barbara, Stefanowicz Joanna, Stachowicz-Stencel Teresa, Kozlowska Marta, Adamkiewicz-Drozynska Elzbieta, Balcerska Anna
Department of Hematology, Oncology and Endocrinology, Medical University of Gdansk, Poland.
J Pediatr Hematol Oncol. 2012 Mar;34(2):137-9. doi: 10.1097/MPH.0b013e3182172532.
Methemoglobinemia is a rare congenital or acquired disease of increased blood methemoglobin concentration. We documented 2 cases of children suffering from neuroblastoma whose postchemotherapy anemia, leucopenia, and stomatitis were complicated by methemoglobinemia after using a formulary oral gel (7.5% benzocaine, doxycycline, nystatin, glycerin). The complication resulted in hospital treatment. Percutaneous oxygen saturation remained at 85% and 87% despite administration of 100% oxygen through a nonrebreather mask. Arterial blood gas analysis showed an oxygen saturation of 98% and 97%, respectively. Spectroscopic measurement showed methemoglobin concentration of 42% and 35.5%, respectively. After red blood cell transfusion and oral ascorbic acid in case 1 and methylene blue in case 2, the patients' condition improved. Although the benzocaine gel is not in use in several medical systems, it should be considered as a possible reason for methemoglobinemia.
高铁血红蛋白血症是一种血液中高铁血红蛋白浓度升高的罕见先天性或后天性疾病。我们记录了2例神经母细胞瘤患儿，他们在使用一种处方口腔凝胶（7.5%苯佐卡因、多西环素、制霉菌素、甘油）后，化疗后的贫血、白细胞减少和口腔炎并发高铁血红蛋白血症。该并发症导致住院治疗。尽管通过非重复呼吸面罩给予100%氧气，但经皮血氧饱和度分别维持在85%和87%。动脉血气分析显示氧饱和度分别为98%和97%。光谱测量显示高铁血红蛋白浓度分别为42%和35.5%。在第1例患者接受红细胞输注和口服抗坏血酸，第2例患者接受亚甲蓝治疗后，患者病情有所改善。尽管苯佐卡因凝胶在一些医疗系统中未被使用，但应将其视为高铁血红蛋白血症的一个可能原因。
