ROLE OF HIGH DOSE ASCORBIC ACID IN TREATMENT OF METHAMOGLOBINEMIA
(Abstract release date: 05/19/16)
EHA Library. Sahu K. 06/09/16; 134652; PB1752
Dr. Kamal Sahu
Contributions
Contributions
Abstract
Abstract: PB1752
Type: Publication Only
Background
Methaemoglobin (MetHb) is an oxidized form of haemoglobin. MetHb has high affinity for oxygen, resulting decrease delivery of oxygen to the tissue. It can be congenital but in clinical practice drugs induced acquired form is more common. Methylene blue is used as first line therapy but the role of vitamin C in the treatment of methaemoglobinemia is yet to be established. Here we are presenting our experience with high dose of vitamin C used successfully to treated methamoglobinemia.
Aims
To study the role of high dose of ascorbic acid for treatment of methamoglobinemia
Methods
This study was conducted over the span of 3 months (Nov 2015-Jan 2016). All patients visiting emergency services with suspected methamoglobinemia were included. In total we found three cases of the proven methamoglobinemia. Patients were given the best supportive therapy including haemodialysis, PRBCs, oxygen supplementation etc. All three patients were given high dose of ascorbic acid (2000mg/day).
Results
Table 1 mentions in detail the demographic details of patients included in the study. Two out of three patients had history of accidental consumption of inciting agent, while the third was prescribed dapsone for immune thrombocytopenia. Case 2 developed massive intravascular haemolysis leading to acute kidney injury requiring haemodialysis (5 sessions). All our patients were normal G6PD activity. Due to unavailability of methylene blue, it was decided to give high dose of ascorbic acid as an anti-oxidant (2000mg/day for 5 days followed by gradual tapering) to all these patients. All patients responded dramatically to this medication and had reduction of Meth-Hb levels. Table 1. Treatment of cases of methamoglobinemia with 2000mg/day of Ascorbic acid
Conclusion
Higher doses of ascorbic acid (2000mg/day) has proven to be beneficial in cases of methamoglobinemia.
Session topic: E-poster
Keyword(s): Dapsone, G6PD
Type: Publication Only
Background
Methaemoglobin (MetHb) is an oxidized form of haemoglobin. MetHb has high affinity for oxygen, resulting decrease delivery of oxygen to the tissue. It can be congenital but in clinical practice drugs induced acquired form is more common. Methylene blue is used as first line therapy but the role of vitamin C in the treatment of methaemoglobinemia is yet to be established. Here we are presenting our experience with high dose of vitamin C used successfully to treated methamoglobinemia.
Aims
To study the role of high dose of ascorbic acid for treatment of methamoglobinemia
Methods
This study was conducted over the span of 3 months (Nov 2015-Jan 2016). All patients visiting emergency services with suspected methamoglobinemia were included. In total we found three cases of the proven methamoglobinemia. Patients were given the best supportive therapy including haemodialysis, PRBCs, oxygen supplementation etc. All three patients were given high dose of ascorbic acid (2000mg/day).
Results
Table 1 mentions in detail the demographic details of patients included in the study. Two out of three patients had history of accidental consumption of inciting agent, while the third was prescribed dapsone for immune thrombocytopenia. Case 2 developed massive intravascular haemolysis leading to acute kidney injury requiring haemodialysis (5 sessions). All our patients were normal G6PD activity. Due to unavailability of methylene blue, it was decided to give high dose of ascorbic acid as an anti-oxidant (2000mg/day for 5 days followed by gradual tapering) to all these patients. All patients responded dramatically to this medication and had reduction of Meth-Hb levels. Table 1. Treatment of cases of methamoglobinemia with 2000mg/day of Ascorbic acid
| Age/Sex | Precipitating factor | Baseline Meth-Hb | Baseline disease | Outcome |
| 45/M | Dapsone (300mg/day) for ITP | 25 | Immune thrombocytopenia | Alive |
| 15/M | Naphthalene ball poisoning | 25.5% | None | Alive |
| 25/M | Paint thinner poisoning | 46.4 | None | Alive |
Conclusion
Higher doses of ascorbic acid (2000mg/day) has proven to be beneficial in cases of methamoglobinemia.
Session topic: E-poster
Keyword(s): Dapsone, G6PD
Abstract: PB1752
Type: Publication Only
Background
Methaemoglobin (MetHb) is an oxidized form of haemoglobin. MetHb has high affinity for oxygen, resulting decrease delivery of oxygen to the tissue. It can be congenital but in clinical practice drugs induced acquired form is more common. Methylene blue is used as first line therapy but the role of vitamin C in the treatment of methaemoglobinemia is yet to be established. Here we are presenting our experience with high dose of vitamin C used successfully to treated methamoglobinemia.
Aims
To study the role of high dose of ascorbic acid for treatment of methamoglobinemia
Methods
This study was conducted over the span of 3 months (Nov 2015-Jan 2016). All patients visiting emergency services with suspected methamoglobinemia were included. In total we found three cases of the proven methamoglobinemia. Patients were given the best supportive therapy including haemodialysis, PRBCs, oxygen supplementation etc. All three patients were given high dose of ascorbic acid (2000mg/day).
Results
Table 1 mentions in detail the demographic details of patients included in the study. Two out of three patients had history of accidental consumption of inciting agent, while the third was prescribed dapsone for immune thrombocytopenia. Case 2 developed massive intravascular haemolysis leading to acute kidney injury requiring haemodialysis (5 sessions). All our patients were normal G6PD activity. Due to unavailability of methylene blue, it was decided to give high dose of ascorbic acid as an anti-oxidant (2000mg/day for 5 days followed by gradual tapering) to all these patients. All patients responded dramatically to this medication and had reduction of Meth-Hb levels. Table 1. Treatment of cases of methamoglobinemia with 2000mg/day of Ascorbic acid
Conclusion
Higher doses of ascorbic acid (2000mg/day) has proven to be beneficial in cases of methamoglobinemia.
Session topic: E-poster
Keyword(s): Dapsone, G6PD
Type: Publication Only
Background
Methaemoglobin (MetHb) is an oxidized form of haemoglobin. MetHb has high affinity for oxygen, resulting decrease delivery of oxygen to the tissue. It can be congenital but in clinical practice drugs induced acquired form is more common. Methylene blue is used as first line therapy but the role of vitamin C in the treatment of methaemoglobinemia is yet to be established. Here we are presenting our experience with high dose of vitamin C used successfully to treated methamoglobinemia.
Aims
To study the role of high dose of ascorbic acid for treatment of methamoglobinemia
Methods
This study was conducted over the span of 3 months (Nov 2015-Jan 2016). All patients visiting emergency services with suspected methamoglobinemia were included. In total we found three cases of the proven methamoglobinemia. Patients were given the best supportive therapy including haemodialysis, PRBCs, oxygen supplementation etc. All three patients were given high dose of ascorbic acid (2000mg/day).
Results
Table 1 mentions in detail the demographic details of patients included in the study. Two out of three patients had history of accidental consumption of inciting agent, while the third was prescribed dapsone for immune thrombocytopenia. Case 2 developed massive intravascular haemolysis leading to acute kidney injury requiring haemodialysis (5 sessions). All our patients were normal G6PD activity. Due to unavailability of methylene blue, it was decided to give high dose of ascorbic acid as an anti-oxidant (2000mg/day for 5 days followed by gradual tapering) to all these patients. All patients responded dramatically to this medication and had reduction of Meth-Hb levels. Table 1. Treatment of cases of methamoglobinemia with 2000mg/day of Ascorbic acid
| Age/Sex | Precipitating factor | Baseline Meth-Hb | Baseline disease | Outcome |
| 45/M | Dapsone (300mg/day) for ITP | 25 | Immune thrombocytopenia | Alive |
| 15/M | Naphthalene ball poisoning | 25.5% | None | Alive |
| 25/M | Paint thinner poisoning | 46.4 | None | Alive |
Conclusion
Higher doses of ascorbic acid (2000mg/day) has proven to be beneficial in cases of methamoglobinemia.
Session topic: E-poster
Keyword(s): Dapsone, G6PD
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