Acute life-threatening methaemoglobinaemia following ingestion of chloroquine

A 25 year old man was rushed to the emergency department when he was found unconscious in his room after taking two chloroquine tablets (600 mg base) for fever prescribed by local practitioner. On examination, the patient was unconscious and deep cyanosis was present on lips, tongue, oral cavity, na...

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Bibliographic Details
Published in:BMJ case reports 2012-03, Vol.2012 (mar20 1), p.bcr1220115383-bcr1220115383
Main Authors: Rizvi, Imran, Zaman, Shamsuz, Zaidi, Noorin, S, Mohammed Asif, Abdali, Nasar
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Antimalarials - adverse effects
Antiparasitic agents
Asia
Blood
Chloroquine - adverse effects
Cyanosis
Diagnosis, Differential
Drug dosages
Emergency medical care
Enzyme Inhibitors - therapeutic use
Enzymes
Fever - drug therapy
Findings That Shed New Light on the Possible Pathogenesis of a Disease or an Adverse Effect
Hemoglobin
Humans
Indian Subcontinent
Male
Methemoglobinemia - chemically induced
Methemoglobinemia - diagnosis
Methylene Blue - therapeutic use
Oxygen saturation
Patients
Poisoning
Pulse oximetry
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Summary:A 25 year old man was rushed to the emergency department when he was found unconscious in his room after taking two chloroquine tablets (600 mg base) for fever prescribed by local practitioner. On examination, the patient was unconscious and deep cyanosis was present on lips, tongue, oral cavity, nail beds and finger tips. Subsequent laboratory investigation revealed methaemoglobin level of 54%. Diagnosis of chloroquine-induced methaemoglobinaemia was made and methylene blue (1 mg/kg) was administered. The patient improved dramatically and was discharged following day.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr.12.2011.5383