Role of red blood cell exchange for treatment of acquired methemoglobinemia in a patient of aniline dye poisoning

Abstract

Typical indication for red blood cell (RBC) exchange is sickle cell disease and its related complications. However, one of the miscellaneous indications of RBC exchange is for the patients of methemoglobinemia who are refractory to treatment by methylene blue. Acquired methemoglobinemia is more common than any genetic causes. Acquired methemoglobinemia is caused by toxins that oxidize heme iron, notably nitrate and nitrite-containing compounds. For patients failing to respond to the standard treatment with methylene blue or in whom its use is contraindicated, hyperbaric oxygen or RBC exchange is indicated. We report a case which was refractory to methylene blue.

Keywords

• Acquired methemoglobinemia
• red blood cell exchange
• refractory to methylene blue