甲氧氯普胺诱发的儿童高铁血红蛋白血症:一个临床病例

M. S. Pavlova, S. N. Zainagutdinova
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引用次数: 0

摘要

导言高铁血红蛋白血症是一种罕见的疾病,其特点是血液中高铁血红蛋白水平升高,导致化学性缺氧。最常见的症状是中心性紫绀,氧疗无效。由于高铁血红蛋白血症的临床表现无特异性且缺乏认知,因此很难诊断。准确诊断需要全面了解病史、鉴别诊断并通过实验室检查进行确认。本研究的目的是证明抗坏血酸在治疗一名长期服用甲氧氯普胺的 11 岁男孩急性继发性高铁血红蛋白血症中的成功应用。对一名长期服用甲氧氯普胺的 11 岁男孩急性继发性高铁血红蛋白血症的临床过程进行了回顾性分析,该男孩需要接受氧疗和肠外注射抗坏血酸溶液。临床表现、实验室指标的特征性变化以及及时使用抗坏血酸治疗的效果受到了特别关注。在开始治疗的 24 小时内,临床和实验室指标均有所改善。在处方可诱发高铁血红蛋白血症的药物时,应谨慎考虑剂量、持续时间和使用频率。此外,还应注意甲氧氯普胺与其他可能影响铁血黄素氧化反应的药物联合使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Methemoglobinemia in a child induced by metoclopramide: a clinical case
Introduction. Methemoglobinemia is a rare condition characterized by an elevated level of methemoglobin in the blood, leading to chemical hypoxia. The most common symptom is central cyanosis refractory to oxygen therapy. Diagnosis of methemoglobinemia is difficult due to the nonspecific clinical presentation and lack of awareness. Accurate diagnosis requires a thorough medical history, differential diagnosis, and confirmation through laboratory investigations.The objective was to demonstrate the successful use of ascorbic acid in the management of acute secondary methemoglobinemia in an 11-year-old boy on prolonged metoclopramide therapy.Materials and methods. The retrospective analysis was conducted on the clinical course of acute secondary methemoglobinemia in the 11-year-old boy on prolonged metoclopramide therapy, necessitating oxygen therapy and parenteral administration of ascorbic acid solution. Special attention was given to the clinical presentation, characteristic changes in laboratory parameters, and the effectiveness of timely ascorbic acid therapy. Clinical and laboratory improvement was achieved within 24 hours of treatment initiation.Conclusion. Caution should be exercised when prescribing medications that can induce methemoglobinemia, taking into account dosage, duration, and frequency of use. Furthermore, careful attention should be given to the combination of metoclopramide with other drugs that may affect iron heme oxidation reactions.
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