Queirós Catarina, Salvador Pedro, Ventura Ana, Lopes Daniela
Serviço de Dermatologia. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.
Serviço de Medicina Interna. Centro Hospitalar de Vila Nova de Gaia-Espinho. Vila Nova de Gaia. Portugal.
Acta Med Port. 2017 Oct 31;30(10):753-756. doi: 10.20344/amp.8722.
Methemoglobinemia is a potentially fatal condition, mainly acquired after intoxication by certain drugs. To this date, only three cases associated with paracetamol have been reported. This case report describes a patient with autosomal dominant polycystic kidney disease undergoing hemodialysis who was self-medicated with acetaminophen for seven days (at a daily dose of 3 g); the patient went to the hospital after noticing the appearance of a diffuse brownish skin tone, without other symptoms. Arterial blood analysis revealed an increase in methemoglobin levels, with biochemistry showing an increase in total bilirubin and alanine aminotransferase. Paracetamol was discontinued and on reassessment nine days after the onset of symptoms the patient had a clear improvement in her skin color, with normalization of methemoglobin levels.
高铁血红蛋白血症是一种潜在的致命疾病，主要在某些药物中毒后获得。迄今为止，仅报告了3例与对乙酰氨基酚相关的病例。本病例报告描述了一名接受血液透析的常染色体显性多囊肾病患者，其自行服用对乙酰氨基酚7天（每日剂量3克）；患者在注意到皮肤出现弥漫性棕褐色后前往医院，无其他症状。动脉血液分析显示高铁血红蛋白水平升高，生化检查显示总胆红素和丙氨酸转氨酶升高。停用对乙酰氨基酚，在症状出现9天后重新评估时，患者皮肤颜色明显改善，高铁血红蛋白水平恢复正常。
