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

Journal of Medical Case Reports

David Grimaldi¹  Jacques Creteur¹  Mickael Gardette¹  Alexandre Brasseur¹  Fabio Silvio Taccone¹  Sophie Lorent² 

[1] Department of Intensive Care Erasme Hospital, Free University of Brussels, Route de Lennik 808, 1070, Brussels, Belgium;Department of Pharmacy, Free University of Brussels, Brussels, Belgium;

关键词: Intoxication;    Multiple organ failure;    Methamphetamine;    Patent Blue;    Hemoadsorption;    Case report;   

DOI  :  10.1186/s13256-020-02657-6

来源: Springer

【 摘 要 】

BackgroundIntoxication 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 reportA 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.ConclusionsThis 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.

【 授权许可】

CC BY