Rush hemolysis. A 'bite-cell' hemolytic anemia associated with volatile liquid nitrite use

Volatile nitrites are illegally marketed compounds that have been inhaled by persons who believe that they cause sexual arousal. These substances have been associated with significant hemolysis of red blood cells in patients with decreased or normal glucose-6-phosphate dehydrogenase levels because such nitrites act as cell-membrane oxidants. We report herein a case of hemolysis in a patient with an underlying glucose-6-phosphate dehydrogenase deficiency associated with the use of volatile nitrites, and we also review the literature of volatile nitrite-induced hemolytic anemia.