Hemoadsorption to treat severe iatrogenic intoxication with Patent Blue: a case report

BACKGROUND: Intoxication with Patent Blue V [sodium compound of (diethylamino-4-phenyl)(hydroxy-5-disulfo-2,4-phenyl) methanol] can lead to high levels of methemoglobin and metabolic acidosis. In severe cases and if not rapidly eliminated from the plasma, this can lead to multiple organ failure and...

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Autores principales: Taccone, Fabio Silvio, Gardette, Mickael, Creteur, Jacques, Brasseur, Alexandre, Lorent, Sophie, Grimaldi, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7870281/
https://www.ncbi.nlm.nih.gov/pubmed/33557948
http://dx.doi.org/10.1186/s13256-020-02657-6
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author Taccone, Fabio Silvio
Gardette, Mickael
Creteur, Jacques
Brasseur, Alexandre
Lorent, Sophie
Grimaldi, David
author_facet Taccone, Fabio Silvio
Gardette, Mickael
Creteur, Jacques
Brasseur, Alexandre
Lorent, Sophie
Grimaldi, David
author_sort Taccone, Fabio Silvio
collection PubMed
description BACKGROUND: Intoxication with Patent Blue V [sodium compound of (diethylamino-4-phenyl)(hydroxy-5-disulfo-2,4-phenyl) methanol] can lead to high levels of methemoglobin and metabolic acidosis. In severe cases and if not rapidly eliminated from the plasma, this can lead to multiple organ failure and death. CASE REPORT: A 27-year-old Asian woman (original from Vietnam) was admitted after ecstasy intoxication resulting in multi-organ failure (acute respiratory distress syndrome, metabolic acidosis, capillary leakage syndrome, renal failure, shock refractory to standard resuscitation). As a consequence, continuous renal replacement therapy and veno-venous extracorporeal membrane oxygenation were started. Methylene blue administration to reverse vasoplegia was decided, but unfortunately, Patent Blue V was erroneously administered, resulting in a severe clinical picture of methemoglobinemia and tissue hypoxia. As a therapeutic intervention, CytoSorb hemoadsorption was initiated, and rapid and significant reduction in plasma methemoglobin, accompanied by improved hemodynamics and normalization in plasma lactate levels, was observed. CONCLUSIONS: This is the first case describing the application of CytoSorb hemoadsorption in a patient with ecstasy intoxication complicated by iatrogenic administration of Patent Blue V. There is a potential role for CytoSorb in drug intoxication, which needs to be confirmed in larger series.
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spelling pubmed-78702812021-02-09 Hemoadsorption to treat severe iatrogenic intoxication with Patent Blue: a case report Taccone, Fabio Silvio Gardette, Mickael Creteur, Jacques Brasseur, Alexandre Lorent, Sophie Grimaldi, David J Med Case Rep Case Report BACKGROUND: Intoxication with Patent Blue V [sodium compound of (diethylamino-4-phenyl)(hydroxy-5-disulfo-2,4-phenyl) methanol] can lead to high levels of methemoglobin and metabolic acidosis. In severe cases and if not rapidly eliminated from the plasma, this can lead to multiple organ failure and death. CASE REPORT: A 27-year-old Asian woman (original from Vietnam) was admitted after ecstasy intoxication resulting in multi-organ failure (acute respiratory distress syndrome, metabolic acidosis, capillary leakage syndrome, renal failure, shock refractory to standard resuscitation). As a consequence, continuous renal replacement therapy and veno-venous extracorporeal membrane oxygenation were started. Methylene blue administration to reverse vasoplegia was decided, but unfortunately, Patent Blue V was erroneously administered, resulting in a severe clinical picture of methemoglobinemia and tissue hypoxia. As a therapeutic intervention, CytoSorb hemoadsorption was initiated, and rapid and significant reduction in plasma methemoglobin, accompanied by improved hemodynamics and normalization in plasma lactate levels, was observed. CONCLUSIONS: This is the first case describing the application of CytoSorb hemoadsorption in a patient with ecstasy intoxication complicated by iatrogenic administration of Patent Blue V. There is a potential role for CytoSorb in drug intoxication, which needs to be confirmed in larger series. BioMed Central 2021-02-09 /pmc/articles/PMC7870281/ /pubmed/33557948 http://dx.doi.org/10.1186/s13256-020-02657-6 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Taccone, Fabio Silvio
Gardette, Mickael
Creteur, Jacques
Brasseur, Alexandre
Lorent, Sophie
Grimaldi, David
Hemoadsorption to treat severe iatrogenic intoxication with Patent Blue: a case report
title Hemoadsorption to treat severe iatrogenic intoxication with Patent Blue: a case report
title_full Hemoadsorption to treat severe iatrogenic intoxication with Patent Blue: a case report
title_fullStr Hemoadsorption to treat severe iatrogenic intoxication with Patent Blue: a case report
title_full_unstemmed Hemoadsorption to treat severe iatrogenic intoxication with Patent Blue: a case report
title_short Hemoadsorption to treat severe iatrogenic intoxication with Patent Blue: a case report
title_sort hemoadsorption to treat severe iatrogenic intoxication with patent blue: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7870281/
https://www.ncbi.nlm.nih.gov/pubmed/33557948
http://dx.doi.org/10.1186/s13256-020-02657-6
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