scholarly journals Amyl Nitrite-Induced Hemolytic Anemia: Acute Therapy and Prevention

Cureus ◽  
2021 ◽  
Author(s):  
Amira H Elshikh ◽  
Ghazal Kango ◽  
Marwa Baalbaki ◽  
Jeffrey Lankowsky ◽  
Amandeep Bawa
Keyword(s):  
Hemolytic Anemia ◽  
Acute Therapy ◽  
Amyl Nitrite

scholarly journals Amyl Nitrite Induced Hemolytic Anemia: Acute Therapy and Prevention

2020 ◽  
Author(s):  
Amira Elshikh ◽  
Ghazal Kango ◽  
Marwa Baalbaki ◽  
Jeffrey Lankowsky ◽  
Amandeep Bawa
Keyword(s):  
Methylene Blue ◽  
Hemolytic Anemia ◽  
G6pd Deficiency ◽  
Positive Outcome ◽  
Acute Therapy ◽  
Atypical Chest Pain ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Patient Reported ◽  
Recreational Use

Abstract Background: Inhaled nitrites have been a substance of recreational use for centuries, primarily among men who have sex with men (MSM). However, there is a lack of awareness of the use of inhaled nitrites in this population and the possible complications and health disparities it carries. This case report highlights the use of inhaled nitrites in an MSM male with an emphasis on the complications induced by this product, including severe hemolytic anemia and methemoglobinemia. Followed by a review of both acute therapy and preventative therapy by increasing provider awareness. Case presentation: A 62-year-old man with a past medical history of glucose-6 phosphate dehydrogenase (G6PD) deficiency presented to the emergency department with atypical chest pain. He was tachypneic and hypotensive with laboratory evidence of end organ damage. He had an acute drop in hemoglobin with elevated bilirubin concerning for acute hemolytic anemia. His arterial blood gas was significant for elevated methemoglobin. The patient reported recent use of “poppers” (inhaled nitrite) which is associated with formation of methemoglobin and hemolytic anemia. Given the severity of his symptoms and elevated methemoglobin, he met criteria for methylene blue administration. However, his G6PD deficiency is a contraindication to methylene blue and the patient was treated conservatively with a positive outcome. Conclusion: The following report presents a unique scenario in which a G6PD deficient patient presented with hemolytic anemia and methemoglobinemia after recreational use of inhaled nitrites. The case was complicated with the management challenge of methemoglobinemia in a patient with G6PD deficiency. Prior literature has shown that the use of nitrites is a predictor for high-risk sexual behavior and is associated with positive human immunodeficiency virus (HIV) status. Increasing provider awareness for appropriate counseling is of importance.

Amyl nitrite-induced hemolytic anemia

1989 ◽  
Vol 86 (2) ◽  
pp. 252-254 ◽  
Author(s):  
James C. Brandes ◽  
Jose A. Bufill ◽  
Anthony V. Pisciotta
Keyword(s):  
Hemolytic Anemia ◽  
Amyl Nitrite

Autoimmune hemolytic anemia

1975 ◽  
Vol 135 (10) ◽  
pp. 1293-1300 ◽  
Author(s):  
J. V. Dacie
Keyword(s):  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia

Letter: Heinz body hemolytic anemia

1976 ◽  
Vol 136 (9) ◽  
pp. 1067a-1067
Author(s):  
E. P. Gabor
Keyword(s):  
Hemolytic Anemia ◽  
Heinz Body

Giant cell hepatitis and Coomb’s positive autoimmune hemolytic anemia: a case report and literature review

2014 ◽  
Vol 25 (1) ◽  
Author(s):  
Hasan M. Isa ◽  
◽  
Lina F. Al Ali ◽  
Afaf M. Mohamed ◽  
Rawia M. Hamad ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Giant Cell ◽  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Giant Cell Hepatitis
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