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A dessert containing nitre powder caused acquired methemoglobinemia in three patients. While adults responded well to methylene blue, the child required intensive care, highlighting age-related differences in treatment response.

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Area of Science:

  • Toxicology
  • Clinical Medicine
  • Pediatrics

Background:

  • Acquired methemoglobinemia is often caused by drugs or toxins, with topical benzocaine being a common culprit.
  • Nitrites, found in substances like nitre powder, are known causes of methemoglobinemia.

Observation:

  • Three patients (ages 5, 33, 86) presented with severe symptoms including hypotension, cyanosis, and hypoxia after consuming a dessert with nitre powder.
  • Symptoms were unresponsive to oxygen therapy, indicating a serious underlying condition.

Findings:

  • Adult patients showed significant improvement after a single dose of methylene blue.
  • The 5-year-old child experienced minimal improvement with two methylene blue doses, necessitating intensive care and transfer.

Implications:

  • This case series identifies a novel food source for acquired methemoglobinemia.
  • Age may influence the severity and treatment response to methylene blue in pediatric methemoglobinemia cases.