Tetta Venkata Sarma Jayant, Suvvari Tarun Kumar, Sagili Sushmitha Reddy, Kata Srinivasa Rajasekhar, Karangula Sindhuja, Singh Tejinder, Thomas Vimal
Government Medical College (GMC), Srikakulam, Andhra Pradesh, India.
Squad Medicine and Research (SMR), Amadalavalasa, Andhra Pradesh, India.
Clin Med Insights Case Rep. 2025 Aug 25;18:11795476251370548. doi: 10.1177/11795476251370548. eCollection 2025.
Methemoglobinemia is a rare but potentially life-threatening condition characterized by the oxidation of hemoglobin iron from ferrous (Fe²⁺) to ferric (Fe³⁺) state, impairing its oxygen-carrying capacity. Acquired forms can be triggered by exposure to oxidizing agents, such as nitrobenzene. We present the case of a 32-year-old female who developed symptomatic methemoglobinemia following oral ingestion of a commercial stimulant product containing nitrobenzene. She presented with peripheral cyanosis, breathlessness, and hypoxia unresponsive to oxygen therapy. A diagnosis of methemoglobinemia was confirmed, and prompt administration of intravenous methylene blue led to rapid clinical improvement. This case emphasizes the importance of early recognition of acquired methemoglobinemia in the context of toxic exposure, especially when conventional respiratory or cardiac pathology is excluded. Methylene blue remains the first-line antidote, offering effective and timely reversal of symptoms.
高铁血红蛋白血症是一种罕见但可能危及生命的病症，其特征是血红蛋白铁从亚铁（Fe²⁺）氧化为高铁（Fe³⁺）状态，从而损害其携氧能力。获得性形式可由接触氧化剂引发，如硝基苯。我们报告一例32岁女性病例，该患者在口服含有硝基苯的商业兴奋剂产品后出现有症状的高铁血红蛋白血症。她表现为外周性发绀、呼吸急促和对氧疗无反应的低氧血症。高铁血红蛋白血症的诊断得到证实，及时静脉注射亚甲蓝使临床症状迅速改善。该病例强调了在有毒暴露情况下早期识别获得性高铁血红蛋白血症的重要性，尤其是在排除传统呼吸或心脏病理学情况时。亚甲蓝仍然是一线解毒剂，能有效且及时地逆转症状。
