A Case of Methemoglobinemia by Hyponex in Toxication

DOI 14 References
  • Uemura Shuji
    Department of Emergency and Critical Care Medicine, Medical Corporation Caress Alliance, Nikko Memorial Hospital
  • Tanno Katsutoshi
    Department of Emergency and Critical Care Medicine, Medical Corporation Caress Alliance, Nikko Memorial Hospital
  • Hirayama Suguru
    Department of Emergency and Critical Care Medicine, Medical Corporation Caress Alliance, Nikko Memorial Hospital

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  • ハイポネックス（窒素，リン酸，カリ混合化学肥料）大量服用によりメトヘモグロビン血症を生じた１例

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A 63-year-old female was admitted to our Emergency Department 18 hrs after ingesting 0.9 L of distilled white liquor and about 150 ml of liquid fertilizer (Hyponex®), in an attempted suicide. Hyperkalemia and methemoglobinemia (arterial methemoglobin 25.6%) were present. Following admission, the level of methemoglobin gradually decreased and at 12 hrs after admission, the level had returned to normal. The patient was discharged on the third day of hospitalization. Deaths due to Hyponex? have been reported but there have been no reports of it leading to the development of methemoglobinemia. Methemoglobin is produced when nitrates are reduced to nitrites within the body. We suspected oxidation of hemoglobin to methemoglobin by nitrates within the blood. Reports of poisoning by liquid fertilizer are uncommon, but caution is advised because there is the possibility that it may lead to methemoglobinemia.

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