Division of Neonatology, St Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, Pennsylvania
Division of Neonatology, St Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, Pennsylvania.
Pediatrics. 2019 Jun;143(6). doi: 10.1542/peds.2018-3619. Epub 2019 May 7.
Naphthalene poisoning due to exposure to mothballs is a common cause of toxicity in children worldwide. Naphthalene toxicity is known to cause hemolytic anemia, methemoglobinemia, and hepatic and renal injury. Neonates are more susceptible to the effects of oxidative stress from naphthalene because of their low glutathione stores and immaturity of hepatic enzymes. However, there are no reported cases of chronic fetal exposure to naphthalene during pregnancy. We report a novel case of chronic fetal exposure to naphthalene-containing mothballs that occurred from the second trimester through the third trimester of pregnancy. Our patient presented with hyperbilirubinemia, requiring exchange transfusion, severe hemolytic anemia, pulmonary hypertension, respiratory failure, and renal failure and progressed to develop "bronze baby" syndrome. Pregnant mothers should be diligently screened for such exposures and if found should receive psychiatric evaluation and counseling to prevent such devastating effects in neonates.
萘中毒是全世界儿童中毒的常见原因,主要是由于接触卫生球所致。萘中毒已知可导致溶血性贫血、高铁血红蛋白血症和肝肾功能损伤。由于新生儿谷胱甘肽储量低且肝酶不成熟,因此更容易受到萘的氧化应激影响。然而,据报道,在怀孕期间,胎儿慢性暴露于萘的情况并不常见。我们报告了一例新的慢性胎儿暴露于萘卫生球的病例,该病例发生在妊娠中期至妊娠晚期。我们的患者表现为高胆红素血症,需要换血,严重溶血性贫血,肺动脉高压,呼吸衰竭和肾衰竭,并逐渐发展为“青铜婴儿”综合征。孕妇应仔细筛查此类暴露情况,如果发现,应进行精神评估和咨询,以防止对新生儿造成此类严重影响。