Geffner M E, Powars D R, Choctaw W T
West J Med. 1981 Jan;134(1):7-10.
Cases of acquired methemoglobinemia have been identified with increasing frequency in Los Angeles during the last several years. Among 18 patients, both infants and adults, the most commonly incriminated agent was silver nitrate used for topical antibacterial prophylaxis of burn wounds. One burned child died from overwhelming septicemia complicated by hypoxia with a methemoglobin level of 5.4 grams per dl. Other causative factors included nitrate-rich vegetables used in early infancy, additives in ethnic foods, and prescribed and overdosed drugs. Discontinuation of the precipitating agent and methylene blue therapy were usually followed by prompt improvement. In burned patients treated with silver nitrate, careful regular monitoring of serum methemoglobin levels and early initiation of specific therapy are mandatory.
在过去几年中，洛杉矶获得性高铁血红蛋白血症的病例被发现的频率越来越高。在18例患者中，既有婴儿也有成人，最常见的致病因素是用于烧伤创面局部抗菌预防的硝酸银。一名烧伤儿童死于严重败血症并伴有缺氧，其高铁血红蛋白水平为每分升5.4克。其他致病因素包括婴儿早期食用的富含硝酸盐的蔬菜、民族食品中的添加剂以及处方药物和过量用药。停用致病剂并进行亚甲蓝治疗后，病情通常会迅速改善。在用硝酸银治疗的烧伤患者中，必须仔细定期监测血清高铁血红蛋白水平并尽早开始特异性治疗。
