Work

Symptomatic Methemoglobinemia at a Relatively Low Methemoglobin Level After Aniline Exposure in a Patient With Hemoglobin D Trait

Year: 2025

Type: article

Abstract: Methemoglobinemia is a condition in which hemoglobin is oxidized, impairing its ability to bind and transport oxygen, leading to tissue hypoxia. We report a rare case of symptomatic methemoglobinemia in a patient with a previously undiagnosed hemoglobin D (Hb D) trait, who developed symptoms at a relatively low methemoglobin (MetHb) level following exposure to aniline. A 57-year-old male who works in a garment shop presented to the emergency department with chest pain, dyspnea, and low oxygen saturation unresponsive to high-concentration oxygen therapy. A discrepancy between arterial oxygen partial pressure (pO₂) and oxygen saturation (sO₂) raised suspicion for methemoglobinemia, which was confirmed by an elevated MetHb level of 11.3%. Hemoglobin electrophoresis revealed the presence of the Hb D trait. The patient's recent handling of newly purchased blue jeans in a poorly ventilated stockroom implicated aniline dye as the likely cause of his methemoglobinemia. Treatment with methylene blue (MB) and ascorbic acid resulted in rapid clinical improvement and normalization of MetHb levels. This observation raises the possibility that Hb D may lower the MetHb level at which symptoms develop, a hypothesis that warrants further investigation.

Source: Cureus

DOI: 10.7759/cureus.88060

Authors: Omer Abdelfadiel, Yasir Abdel Latif Elbashir Ahmed, Intisar Abdulrahman, Walaa Abdelmaaboud

Institution: University Hospitals of North Midlands NHS Trust

Language: English

Topic: Methemoglobinemia and Tumor Lysis Syndrome

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4412471470