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Life-threatening intoxication with methylene bis(thiocyanate): clinical picture and pitfalls. A case report

Claude Braun1, Rainer Birck, Manfred V Singer

  • 1Department of Medicine V, Nephrology/Endocrinology/Rheumatology, University Medical Center Mannheim, University of Heidelberg, D-68135 Mannheim, Germany. cbraun@rumms.uni-mannheim.de

BMC Emergency Medicine
|April 13, 2006
PubMed
Abstract

Insights

Methylene bis(thiocyanate) (MBT) industrial exposure can cause severe methemoglobinemia and multi-organ failure. Early treatment with molecular adsorbent recirculating system (MARS) may aid liver recovery.

Area of Science:

  • Industrial toxicology
  • Environmental health
  • Critical care medicine

Background:

  • Methylene bis(thiocyanate) (MBT) is a biocide used in industrial settings.
  • It inhibits algae, fungi, and bacteria in water cooling systems and paper mills.

Purpose of the Study:

  • To report the first case of severe intoxication from inhaled MBT powder.
  • To highlight the clinical presentation and management of MBT poisoning.

Main Methods:

  • Case report of an industrial worker with acute MBT inhalation.
  • Immediate intensive care unit admission with mechanical ventilation and hemodialysis.
  • Treatment with molecular adsorbent recirculating system (MARS) for liver support.

Main Results:

  • Rapid development of cyanosis and respiratory failure due to severe methemoglobinemia.
  • Progression to multi-organ failure affecting liver, kidneys, and lungs.
  • Successful recovery of hepatic function with MARS therapy.

Conclusions:

  • MBT intoxication is a life-threatening condition characterized by methemoglobinemia and organ damage.
  • Extracorporeal liver albumin dialysis (MARS) shows promise in managing hepatic failure from MBT poisoning.

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