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Utility of Lipid Sink in Treatment of Refractory Acquired Methemoglobinemia. A Case Report

Anuj Khatr1, Anil Sachdev, Suresh Gupta, Dhiren Gupta, Neeraj Gupta and Nisha Kumari

Methemoglobinemia can be congenital or acquired. Acquired methemoglobinemia occurs as a result of ingestion of some substances such as toluene, nitrates. Patient presents with cyanosis which is not explainable by the respiratory or cardiac cause. Most frequently used drug in treatment is methylene blue. We report a case of a patient with severe acquired methemoglobinemia in 14 months old baby, due to ingestion of toluene. He was cyanosed which was refractory to oxygen therapy and without any cardiac and respiratory disease. He had persistent high levels of methemoglobin, despite giving multiple doses of methylene blue and exchange transfusion. Finally, methemoglobin levels were controlled by automated RBC exchange transfusion and intralipid infusion.