Ahmed Noor, Hoy Brent Philip Sew, McInerney J
Emergency Department, Mater Misericordiae University Hospital, Dublin, Ireland.
BMJ Case Rep. 2010 Oct 22;2010:bcr0420102879. doi: 10.1136/bcr.04.2010.2879.
Acquired methaemoglobinaemia is a serious complication caused by many oxidising drugs. It presents as cyanosis unresponsive to oxygen therapy. The case of 33-year-old male patient who presented in our department after noticing blue lips and fingers is presented. He had sniffed 1 g of 'snow' after buying it from a head shop. His oxygen saturation by pulse oximeter on room air at presentation was 90%, which did not improve with supplemental oxygen. Arterial blood gas analyses showed partial pressure of oxygen 37 kPa while on supplemental oxygen and a methaemoglobin concentration greater than 25%. The patient denied using any other recreational drugs and was not on regular treatment. Therefore, a diagnosis of methaemoglobinaemia due to mephedrone, which is the active ingredient of 'snow', was made. Treatment is with intravenous methylene blue. Our patient started to improve so methylene blue was not used and he was discharged after 8 h.
获得性高铁血红蛋白血症是由多种氧化药物引起的严重并发症。其表现为对氧疗无反应的发绀。本文报告了一名33岁男性患者的病例，该患者在发现嘴唇和手指变蓝后前来我院就诊。他从一家烟具店购买了1克“冰毒”并吸食。就诊时在室内空气中经脉搏血氧仪测得的氧饱和度为90%，吸氧后未改善。动脉血气分析显示吸氧时氧分压为37kPa，高铁血红蛋白浓度大于25%。患者否认使用任何其他娱乐性药物，也未接受常规治疗。因此，诊断为由“冰毒”的活性成分甲氧麻黄酮引起的高铁血红蛋白血症。治疗方法是静脉注射亚甲蓝。我们的患者开始好转，因此未使用亚甲蓝，8小时后出院。
