Paracetamol Reactions 1680, p273 - 2 Dec 2017 Methaemoglobinaemia: case report A 78-year-old woman developed methaemoglobinaemia following paracetamol administration [acetaminophen; time to reaction onset not stated]. The woman had autosomal dominant polycystic kidney disease for which she was on haemodialysis for 30 months and mild cognitive impairment due to vascular dementia. She was treated with aspirin [acetylsalicylic acid], calcium acetate/ magnesium carbonate, hydroxyzine and quetiapine. She went to hospital after appearance of a diffuse brownish skin tone. She had haemodialysis the previous day, after which she took oral paracetamol 1g for elevation in axillary temperature. Later, she reported intake of paracetamol 1 g three times daily for previous 7 days for osteoarticular complaints. Increase in percent of methaemoglobin (3.3%) was observed in arterial blood gas analysis, and blood analysis revealed normochromic th normocytic anemia with haemoglobin 11.2 g/dL. The 5 sample of blood biochemistry revealed increase in alanine aminotransferase 62 U/L and total bilirubin 1.62 mg/dL. The diagnosis of paracetamol-related methemoglobinemia was suspected and paracetamol was stopped. After 2 days, bluish skin colour was observed and blood analysis revealed decrease in percent of methaemoglobin (2.9%). Increase in bilirubin and hepatic cytolysis enzymes were noted by analytical study, which supported the diagnosis of paracetamol-related methemoglobinemia. She was discharged and reassessment after 9 days showed improvement in skin colour and no significant changes were noted in analytical study. The blood gas analysis showed normal percentage of methaemoglobin (0.6%). Author comment: "Methemoglobinemia is a potentially fatal condition, mainly acquired after intoxication by certain drugs. To this date, only three cases associated with paracetamol have been reported." "The diagnosis of paracetamol-related methemoglobinemia was suspected, and the patient immediately stopped taking this drug". Queiros C, et al. Methemoglobinemia after paracetamol ingestion: A case report. Acta Medica Portuguesa 30: 753-756, No. 10, Oct 2017. Available from: URL: showToc - Portugal 803284585 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680 Reactions Weekly Springer Journals


Reactions Weekly , Volume 1680 (1) – Dec 2, 2017
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Springer International Publishing
Copyright © 2017 by Springer International Publishing AG, part of Springer Nature
Medicine & Public Health; Drug Safety and Pharmacovigilance; Pharmacology/Toxicology
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