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Updated: Oct 25, 2025

Measuring Nitrite and Nitrate, Metabolites in the Nitric Oxide Pathway, in Biological Materials using the Chemiluminescence Method
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Amyl Nitrite-Induced Hemolytic Anemia: Acute Therapy and Prevention

Amira H Elshikh1, Ghazal Kango1, Marwa Baalbaki1

  • 1Internal Medicine, George Washington University, Washington, USA.

Cureus
|August 4, 2021
PubMed

Insights

Recreational inhaled nitrite use can cause severe hemolytic anemia and methemoglobinemia, especially in individuals with glucose-6 phosphate dehydrogenase (G6PD) deficiency. This case highlights critical health risks in the men who have sex with men (MSM) community.

Area of Science:

  • Toxicology
  • Hematology
  • Public Health

Background:

  • Inhaled nitrites are widely used recreationally, particularly among men who have sex with men (MSM).
  • Awareness of associated health risks and disparities in the MSM population remains limited.
  • Nitrite use is linked to high-risk sexual behaviors and positive human immunodeficiency virus (HIV) status.

Observation:

  • A 62-year-old male with a history of glucose-6 phosphate dehydrogenase (G6PD) deficiency presented with severe symptoms.
  • The patient reported recent recreational use of inhaled nitrites.
  • Clinical presentation included severe hemolytic anemia and methemoglobinemia.

Findings:

  • The patient developed severe hemolytic anemia and methemoglobinemia following inhaled nitrite use.
  • The co-occurrence of methemoglobinemia in a patient with G6PD deficiency presented a complex clinical scenario.
  • This case underscores the potential for severe hematological complications.

Implications:

  • Increased awareness of inhaled nitrite risks is crucial, especially within the MSM community.
  • Healthcare providers should consider G6PD deficiency when evaluating patients with methemoglobinemia after nitrite use.
  • This case highlights the need for targeted health interventions and harm reduction strategies for MSM regarding recreational substance use.
Keywords:
acute hemolytic anemiainhaled nitritesmethemoglobinemiamsmprovider awarenesssubstance recreational use

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