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April 1979, Vol 133, No. 4 >
Article | April 1979

Methemoglobinemia Owing to Rectal-Probe Lubrication FREE

JAMES M. SHERMAN, MD; Kim SMITH, MD
Am J Dis Child. 1979;133(4):439-440. doi:10.1001/archpedi.1979.02130040093023.
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Methemoglobinemia is a cause of cyanosis in the absence of lung or cardiac disease. Nursery outbreaks owing to marking ink on diapers1 and 3.25% triclocarban (3-4-41 trichlorocarbanilide) in the diaper rinse2 have been reported. Benzocaine has caused methemoglobinemia when given as a rectal suppository to infants and children,3-5 when used as an endotracheal tube lubricant in an older child,6 and when used topically on skin7-11 or oral mucosa.12,13 We wish to report another potential route of exposure.

Report of a Case.—A 1,030-g female infant, was born at Tampa (Fla) General Hospital to a 19-year-old gravida 1 four days after spontaneous rupture of the membranes. The estimated gestational age was 27 weeks, and the mother had received two doses of betamethasone. Delivery was spontaneous, and the Apgar scores were 8 and 9, at 1 and 5 minutes of age, respectively. The initial gastric

REFERENCES

1 +
Ramsay DHE, Harvey CC:  Marking ink poisoning . Lancet 1:910-912, 1959;.
2 +
Johnson RR, Navone R, Larson EL:  An unusual epidemic of methemoglobinemia . Pediatrics 31:222-225, 1963;.
3 +
Huges JR:  Infantile methemoglobinemia due to benzocaine suppository . J Pediatr 66:797-799, 1965;.
4 +
Peterson, HD:  Acquired methemoglobinemia in an infant due to benzocaine suppository . N Engl J Med 263:454-455, 1960;.
5 +
Bloch A:  More on infantile methemoglobinemia due to benzocaine suppositories . J Pediatr 67:509-510, 1965;.
6 +
Steinberg JB, Zepernick RG:  Methemoglobinemia during anesthesia . J Pediatr 61:885-886, 1962;.
7 +
Goluboff N, MacFadyen DJ:  Methemoglobinemia in an infant: Associated with application of a tar-benzocaine ointment . J Pediatr 47:222-226, 1955;.
8 +
Wolff JR:  Methemoglobinemia due to benzocaine . Pediatrics 20:915-916, 1957;.
9 +
Goluboff N:  Methemoglobinemia due to benzocaine . Pediatrics 21:340-341, 1958;.
10 +
Haggerty RJ:  Blue baby due to methemoglobinemia . N Engl J Med 267:1303, 1962;.
11 +
Townes PL, Geertsma MA, White MR:  Benzocaine-induced methemoglobinemia . Am J Dis Child 131:697-698, 1977;.
12 +
Ocklitz HW:  Anaesthesin vergift und beim Saugling . Med Klin 44:806-809, 1949;.
13 +
Bernstein BM:  Cyanosis following use of anesthesia (ethyl-aminobenzoate) . Rev Gastroenterol 17:123-124, 1950;.
14 +
Sand RE, Edelmann CM Jr:  Pyridiaminduced methemoglobinemia . J Pediatr 58:845-848, 1961;.
15 +
Ross JD, Desforges JR:  Reduction of methemoglobin by erythrocytes from cord blood: Further evidence of deficient enzyme activity in the newborn period . Pediatrics 23:718-726, 1959;.
16 +
Hibbard BZ, Koenig HM, Lightsey AL, et al:  Severe methemoglobinemia in an infant with glucose-6-phosphate dehydrogenase deficiency . J Pediatr 93:816-818, 1978;.
17 +
Ross JD:  Deficient activity of DPNH-dependent methemoglobin diaphorase in cord blood erythrocytes . Blood 21:51-62, 1963;.
18 +
Jaffe ER, Heller P:  Methemoglobinemia in man , in Moore CV, Brown EB (eds): Progress in Hematology . New York, Grune & Stratton Inc, 1964;, vol 4.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Ramsay DHE, Harvey CC:  Marking ink poisoning . Lancet 1:910-912, 1959;.
2 +
Johnson RR, Navone R, Larson EL:  An unusual epidemic of methemoglobinemia . Pediatrics 31:222-225, 1963;.
3 +
Huges JR:  Infantile methemoglobinemia due to benzocaine suppository . J Pediatr 66:797-799, 1965;.
4 +
Peterson, HD:  Acquired methemoglobinemia in an infant due to benzocaine suppository . N Engl J Med 263:454-455, 1960;.
5 +
Bloch A:  More on infantile methemoglobinemia due to benzocaine suppositories . J Pediatr 67:509-510, 1965;.
6 +
Steinberg JB, Zepernick RG:  Methemoglobinemia during anesthesia . J Pediatr 61:885-886, 1962;.
7 +
Goluboff N, MacFadyen DJ:  Methemoglobinemia in an infant: Associated with application of a tar-benzocaine ointment . J Pediatr 47:222-226, 1955;.
8 +
Wolff JR:  Methemoglobinemia due to benzocaine . Pediatrics 20:915-916, 1957;.
9 +
Goluboff N:  Methemoglobinemia due to benzocaine . Pediatrics 21:340-341, 1958;.
10 +
Haggerty RJ:  Blue baby due to methemoglobinemia . N Engl J Med 267:1303, 1962;.
11 +
Townes PL, Geertsma MA, White MR:  Benzocaine-induced methemoglobinemia . Am J Dis Child 131:697-698, 1977;.
12 +
Ocklitz HW:  Anaesthesin vergift und beim Saugling . Med Klin 44:806-809, 1949;.
13 +
Bernstein BM:  Cyanosis following use of anesthesia (ethyl-aminobenzoate) . Rev Gastroenterol 17:123-124, 1950;.
14 +
Sand RE, Edelmann CM Jr:  Pyridiaminduced methemoglobinemia . J Pediatr 58:845-848, 1961;.
15 +
Ross JD, Desforges JR:  Reduction of methemoglobin by erythrocytes from cord blood: Further evidence of deficient enzyme activity in the newborn period . Pediatrics 23:718-726, 1959;.
16 +
Hibbard BZ, Koenig HM, Lightsey AL, et al:  Severe methemoglobinemia in an infant with glucose-6-phosphate dehydrogenase deficiency . J Pediatr 93:816-818, 1978;.
17 +
Ross JD:  Deficient activity of DPNH-dependent methemoglobin diaphorase in cord blood erythrocytes . Blood 21:51-62, 1963;.
18 +
Jaffe ER, Heller P:  Methemoglobinemia in man , in Moore CV, Brown EB (eds): Progress in Hematology . New York, Grune & Stratton Inc, 1964;, vol 4.

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