A case of severe methemoglobinemia caused by hair dye poisoning.

Abstract

CONTEXT:

Hair dyes are widely used and very popular xenobiotics. Most of these products contain paraphenylenediamine (PPD) that can cause methemoglobinemia. We here report a case of severe methemoglobinemia that we treated using large amounts of methylene blue.

CASE DETAILS:

A 30-year-old man visited a regional hospital with cyanosis. He was congenitally blind and had autism. For several weeks, he had mistaken hair dye for toothpaste. When he arrived at a regional hospital, he was drowsy with cyanosis and his initial serum methemoglobin (MetHb) level was 59.5%. After being treated with 2 mg/kg methylene blue (1 mg/kg × 2 administrations), he was transferred to a tertiary university hospital. Upon presentation at the Emergency Department in the tertiary hospital, his MetHb level was found to be 49.4% and his oxygen saturation was 80%. He was then admitted to the intensive care unit. After treatment with 4 mg/kg methylene blue (1 mg/kg × 4 administrations), he successfully recovered.

DISCUSSION:

Because PPD can result in serious methemoglobinemia, clinicians should test it in cyanotic patients who have been exposed to hair dye for an extended period.

• Authors: S M Ryoo, C H Sohn, B J Oh, W Y Kim, K S Lim
• Journal: Human & experimental toxicology (Hum Exp Toxicol) Vol. 33 Issue 1 Pg. 103-5 (Jan 2014) ISSN: 1477-0903 [Electronic] England
• PMID: 23515496 (Publication Type: Case Reports, Journal Article)

Chemical References

• Enzyme Inhibitors
• Hair Dyes
• Phenylenediamines
• Guanylate Cyclase
• Methylene Blue
• 4-phenylenediamine

Topics

• Accidents, Home
• Adult
• Cyanosis (etiology, prevention & control)
• Emergency Service, Hospital
• Enzyme Inhibitors (administration & dosage, therapeutic use)
• Guanylate Cyclase
• Hair Dyes (toxicity)
• Humans
• Male
• Methemoglobinemia (chemically induced, physiopathology)
• Methylene Blue (administration & dosage, therapeutic use)
• Phenylenediamines (toxicity)
• Severity of Illness Index
• Treatment Outcome