ROBERT BUCKLIN, M.D., F.A.C.P.; M. K. MYINT, M.D.
Among the many causes of acquired methemoglobinemia, that due to ingestion of well water containing high levels of nitrates is an entity one should consider in a cyanotic infant with a negative history and physical findings. Some other causes of methemoglobinemia are aniline, phenacetin, acetanilid, sulfonamides, nitrobenzene, various nitrites, nitroglycerin, bismuth subnitrate, ammonium nitrates, contact with dyed blankets, laundry marks on diapers, freshly dyed shoes, inhalation of nitrous gases in arc welding, and ingestion of crayons containing p-nitroaniline.5
Methemoglobin is a derivative of hemoglobin, where ferrous porphyrin complex is converted to the ferric form, which does not combine with oxygen.3
BUCKLIN R, MYINT MK. FATAL METHEMOGLOBINEMIA DUE TO WELL WATER NITRATES1. Ann Intern Med. ;52:703–705. doi: 10.7326/0003-4819-52-3-703
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Published: Ann Intern Med. 1960;52(3):703-705.
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