Methemoglobinemia after a Mediastinal Stab Wound

Abstract Background Methemoglobinemia is a relatively common, potentially fatal syndrome resulting from oxidative stress. Of the numerous causes identified, toxins are the most common precipitating event. Objectives Describe methemoglobinemia after a stab wound in a man with previously undiagnosed c...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of emergency medicine 2013-11, Vol.45 (5), p.e153-e156
Main Authors: Levine, Michael, MD, O'Connor, Ayrn D., MD, Tasset, Mark, MD
Format: Article
Language:English
Subjects:
Adult
cytochrome b5 reductase
Cytochrome-B Reductase - deficiency
Emergency
Genetic Testing
Humans
Male
Mediastinum - injuries
methemoglobin
methemoglobinemia
Methemoglobinemia - etiology
Oxidative Stress
trauma
Wounds, Stab - complications
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background Methemoglobinemia is a relatively common, potentially fatal syndrome resulting from oxidative stress. Of the numerous causes identified, toxins are the most common precipitating event. Objectives Describe methemoglobinemia after a stab wound in a man with previously undiagnosed cytochrome b5 reductase deficiency. Case Report In this case report, we describe a 27-year-old man with no past medical history who developed clinically significant methemoglobinemia after a mediastinal stab wound. After an extensive toxicologic work-up failed to reveal the etiology of the symptoms, genetic testing was performed, which revealed the individual to have a previously undiagnosed cytochrome b5 reductase deficiency. It is hypothesized that the physiologic stress from the expanding mediastinal stab wound resulted in enough oxidative stress to cause methemoglobinemia in this predisposed individual. A discussion of methemoglobinemia ensues. Conclusion This case describes an uncommon presentation of a common toxicologic condition and presents a discussion regarding the evaluation, management, and pathophysiology of methemoglobinemia.
ISSN:0736-4679
2352-5029
DOI:10.1016/j.jemermed.2013.05.023