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Methaemoglobinaemia in pregnancy with chronic kidney disease an uncommon case: A case report

Mahmut Gok1, Yasemin Gul Aydemir1

  • 1Department of Nephrology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

JPMA. the Journal of the Pakistan Medical Association
|March 23, 2022
PubMed

The development of methaemoglobinaemia due to prilocaine, which is used for local anaesthesia, is a rare, life-threatening, but well-known side effect. The development of this side-effect in a pregnant patient with chronic kidney disease can lead to foetal distress. The case presented here is of a 21-year old pregnant female with chronic kidney disease who required haemodialysis in the 22nd week of pregnancy due to the progression to end-stage kidney disease. During haemodialysis, a right jugular tunneled double-lumen catheter was inserted using prilocaine as the local anaesthetic. Prilocaine-induced methaemoglobinaemia was diagnosed. In the 24-hour follow-up, the methaemoglobin level decreased to normal with oxygen supply of 10-15 L/min, 2 units of erythrocyte suspension and accompanying haemodialysis.

Keywords:
Methemoglobinemia, Prilocaine, Pregnancy, Hemodialysis.

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