多器官衰竭二次于故意的乙氨基过量诱导的甲基红蛋白血症
Mohamed A Abutineh1, Chirag Lodha1, George Mitchell2
1Internal Medicine, Edward Via College of Osteopathic Medicine, Spartanburg, USA.
Cureus
|June 11, 2025
概括
过量服用乙氨基可能会导致甲基血红蛋白血症,这种情况会损害氧气运输. 早期识别和用甲蓝治疗对于疑似乙胺毒性和不明原因的乳酸性酸症患者至关重要.
科学领域:
- 毒理学 毒理学 毒理学
- 紧急医疗 紧急医疗
- 关键的护理关键的护理
背景情况:
- 乙氨基毒性是造成肝损伤的常见原因.
- 甲基血红蛋白血症是乙氨基过量服用的罕见并发症,可导致组织缺氧和多器官功能障碍.
- 在乙氨基过量服用时,临床识别甲基红蛋白血症往往会延迟.
研究的目的:
- 强调在乙氨基过量服用时识别甲基红蛋白血症的重要性.
- 为了呈现一种由乙氨基诱导的甲基红蛋白血症病例.
- 讨论诊断和管理方面的挑战.
主要方法:
- 一个21岁的男性故意服用过量药物的案例报告.
- 包括布洛,乙氨基和漂白剂.
- 诊断工作包括食管胃二透镜 (EGD),肝功能测试和甲血球蛋白水平.
- 用N-乙半氨酸 (NAC) 和甲蓝进行治疗.
主要成果:
- 最初的表现与精神状态的改变和乳酸化.
- 呈现时的正常肝功能测试,延迟转氨酶升高.
- 确诊的甲血球蛋白水平升高,表明甲血球蛋白emia.
- 患者因多系统器官衰竭而死亡,尽管接受了治疗.
结论:
- 在乙氨基过量的情况下,应怀疑甲基红蛋白血症,并与无法解释的乳酸和组织缺氧有关.
- 及时诊断和用甲蓝治疗是必不可少的.
- 这一案例强调了除了肝损伤之外,乙氨基毒性可能会导致严重的,危及生命的并发症.
相关概念视频
Acute Respiratory Failure-I
177
Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
177
Toxic Reactions: Overview
955
When toxic substances penetrate the human body, they disseminate to various tissues, undergoing metabolic changes. This process yields reactive metabolites that may covalently bind with specific target molecules, resulting in toxicity.
Toxicity falls into two primary categories: local and systemic.
Local toxicity appears at the exposure site, such as protein denaturation caused by caustic substances.
In contrast, systemic toxicity requires the toxic agent's absorption and distribution,...
Toxicity falls into two primary categories: local and systemic.
Local toxicity appears at the exposure site, such as protein denaturation caused by caustic substances.
In contrast, systemic toxicity requires the toxic agent's absorption and distribution,...
955
Acute Respiratory Failure-II
179
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
179
Acute Respiratory Failure-III
162
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
162
Phase II Reactions: Glutathione Conjugation and Mercapturic Acid Formation
158
Glutathione, a tripeptide made up of glutamate, cysteine, and glycine, is a critical player in the detoxification of drugs and xenobiotics via a process known as glutathione conjugation or mercapturic acid formation. This phase II biotransformation reaction involves the covalent binding of glutathione to a drug or its metabolite, enhancing the compound's water solubility and enabling its excretion.
Several distinctive characteristics distinguish glutathione conjugation from other phase II...
Several distinctive characteristics distinguish glutathione conjugation from other phase II...
158
Anticholinesterase Agents: Poisoning and Treatment
811
Anticholinesterases, also known as cholinesterase inhibitors, work by blocking the breakdown of acetylcholine, leading to its accumulation in the synaptic cleft. This accumulation indirectly enhances both muscarinic and nicotinic actions. These agents are classified as reversible or irreversible based on their mechanism of action.
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
811


