Aniline-induced refractory methemoglobinemia in polytrauma:
successful management with erythrocytapheresis

J 2025

Aniline-induced refractory methemoglobinemia in polytrauma: successful management with erythrocytapheresis

LECBYCHOVA, Karolina; Marcela KANOVA; Paula DZURNAKOVA; Sarka BLAHUTOVA; Tereza ROMANOVA et al.

Základní údaje

Originální název

Aniline-induced refractory methemoglobinemia in polytrauma: successful management with erythrocytapheresis

Autoři

LECBYCHOVA, Karolina; Marcela KANOVA; Paula DZURNAKOVA; Sarka BLAHUTOVA; Tereza ROMANOVA a Denis BURŠÍK

Vydání

INTERNATIONAL JOURNAL OF EMERGENCY MEDICINE, London, BMC, 2025, 1865-1372

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30221 Critical care medicine and Emergency medicine

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.000 v roce 2024

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/25:00143780

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

Methemoglobinemia; Tissue hypoxia; Erythrocytapheresis; Methylene blue; Aniline dyes; Polytrauma

Štítky

14110233, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 26. 2. 2026 09:46, Mgr. Tereza Miškechová

Anotace

V originále

Background Methemoglobinemia is a life-threatening condition characterized by the inability of hemoglobin to transport oxygen efficiently. This case report describes acquired methemoglobinemia caused by exposure to aniline dye, which was successfully treated with erythrocytapheresis following the insufficient effect of methylene blue. Case presentation A 39-year-old male suffered multiple injuries, including burns and fractures, after falling into a barrel containing aniline. On site, emergency medical services (EMS) intubated the patient, performed chest decompression for pneumothorax, and decontaminated him before transferring him to a trauma centre. In the emergency unit, imaging revealed multiple rib, scapula, and pelvic fractures, retroperitoneal bleeding, and 15% total body surface area (TBS) burns. He was hemodynamically unstable, with metabolic acidosis, an oxygen saturation gap, and an initial methemoglobin level (MetHb) of 19%. Despite methylene blue treatment, the MetHb levels rose to undetectable levels (> 20%), and severe hemodynamic instability, refractory hypoxia, and metabolic derangement required the use of erythrocytapheresis. Conclusion Aniline exposure leads to the oxidation of ferrous iron (Fe2 +) in hemoglobin to ferric iron (Fe3 +), resulting in methemoglobinemia and impaired oxygen delivery. While methylene blue remains the first-line treatment, erythrocytapheresis proved effective in restoring tissue oxygenation in refractory methemoglobinemia complicated by hemorrhagic and traumatic shock.

Citovat

LECBYCHOVA, Karolina; Marcela KANOVA; Paula DZURNAKOVA; Sarka BLAHUTOVA; Tereza ROMANOVA a Denis BURŠÍK. Aniline-induced refractory methemoglobinemia in polytrauma: successful management with erythrocytapheresis. INTERNATIONAL JOURNAL OF EMERGENCY MEDICINE. London: BMC, 2025, roč. 18, č. 1, s. 1-4. ISSN 1865-1372. Dostupné z: https://doi.org/10.1186/s12245-025-01026-8.

@article{2556822,
   author = {Lecbychova, Karolina and Kanova, Marcela and Dzurnakova, Paula and Blahutova, Sarka and Romanova, Tereza and Buršík, Denis},
   article_location = {London},
   article_number = {1},
   doi = {https://doi.org/10.1186/s12245-025-01026-8},
   keywords = {Methemoglobinemia; Tissue hypoxia; Erythrocytapheresis; Methylene blue; Aniline dyes; Polytrauma},
   language = {eng},
   issn = {1865-1372},
   journal = {INTERNATIONAL JOURNAL OF EMERGENCY MEDICINE},
   title = {Aniline-induced refractory methemoglobinemia in polytrauma: successful management with erythrocytapheresis},
   url = {https://link.springer.com/article/10.1186/s12245-025-01026-8},
   volume = {18},
   year = {2025}
}

TY  - JOUR
ID  - 2556822
AU  - Lecbychova, Karolina - Kanova, Marcela - Dzurnakova, Paula - Blahutova, Sarka - Romanova, Tereza - Buršík, Denis
PY  - 2025
TI  - Aniline-induced refractory methemoglobinemia in polytrauma: successful management with erythrocytapheresis
JF  - INTERNATIONAL JOURNAL OF EMERGENCY MEDICINE
VL  - 18
IS  - 1
SP  - 1-4
EP  - 1-4
PB  - BMC
SN  - 18651372
KW  - Methemoglobinemia
KW  - Tissue hypoxia
KW  - Erythrocytapheresis
KW  - Methylene blue
KW  - Aniline dyes
KW  - Polytrauma
UR  - https://link.springer.com/article/10.1186/s12245-025-01026-8
N2  - Background Methemoglobinemia is a life-threatening condition characterized by the inability of hemoglobin to transport oxygen efficiently. This case report describes acquired methemoglobinemia caused by exposure to aniline dye, which was successfully treated with erythrocytapheresis following the insufficient effect of methylene blue. Case presentation A 39-year-old male suffered multiple injuries, including burns and fractures, after falling into a barrel containing aniline. On site, emergency medical services (EMS) intubated the patient, performed chest decompression for pneumothorax, and decontaminated him before transferring him to a trauma centre. In the emergency unit, imaging revealed multiple rib, scapula, and pelvic fractures, retroperitoneal bleeding, and 15% total body surface area (TBS) burns. He was hemodynamically unstable, with metabolic acidosis, an oxygen saturation gap, and an initial methemoglobin level (MetHb) of 19%. Despite methylene blue treatment, the MetHb levels rose to undetectable levels (> 20%), and severe hemodynamic instability, refractory hypoxia, and metabolic derangement required the use of erythrocytapheresis. Conclusion Aniline exposure leads to the oxidation of ferrous iron (Fe2 +) in hemoglobin to ferric iron (Fe3 +), resulting in methemoglobinemia and impaired oxygen delivery. While methylene blue remains the first-line treatment, erythrocytapheresis proved effective in restoring tissue oxygenation in refractory methemoglobinemia complicated by hemorrhagic and traumatic shock.
ER  -

LECBYCHOVA, Karolina; Marcela KANOVA; Paula DZURNAKOVA; Sarka BLAHUTOVA; Tereza ROMANOVA a Denis BURŠÍK. Aniline-induced refractory methemoglobinemia in polytrauma: successful management with erythrocytapheresis. \textit{INTERNATIONAL JOURNAL OF EMERGENCY MEDICINE}. London: BMC, 2025, roč.~18, č.~1, s.~1-4. ISSN~1865-1372. Dostupné z: https://doi.org/10.1186/s12245-025-01026-8.

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