{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T21:19:22Z","timestamp":1760217562344,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>A 39-year-old man presented to the emergency department after falling downstairs after he consumed a large quantity of alcohol. On examination, he had altered mental state (GCS 14), central cyanosis and low oxygen saturation of 86%, despite 100% oxygen being administered. His arterial blood gas confirmed diagnosis of methaemoglobinaemia with a methaemoglobin percentage of 14.08. He was treated successfully with methylthioninium chloride. The patient later admitted to use of recreational poppers (amyl nitrates) the previous evening. The emergency physician is challenged by the presentation of a patient with altered mental state and unexplained low oxygen saturation with concurrent alcohol intoxication but must have a high index of suspicion for methaemoglobinaemia particularly with a history of recreational drug ingestion.<\/jats:p>","DOI":"10.1136\/bcr-2012-007176","type":"journal-article","created":{"date-parts":[[2012,11,21]],"date-time":"2012-11-21T10:38:21Z","timestamp":1353494301000},"page":"bcr2012007176","source":"Crossref","is-referenced-by-count":6,"title":["Pop goes the O<sub>2<\/sub>: a case of popper-induced methaemoglobinamia"],"prefix":"10.1136","volume":"2012","author":[{"given":"Aileen","family":"McCabe","sequence":"first","affiliation":[{"name":"Emergency Department, Waterford Regional Hospital, Waterford, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan","family":"McCann","sequence":"additional","affiliation":[{"name":"Emergency Department, Waterford Regional Hospital, Waterford, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Kelly","sequence":"additional","affiliation":[{"name":"Emergency Department, Wexford General Hospital, Wexford, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2012,11,21]]},"reference":[{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2011.03950.x"},{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.2","unstructured":"Flomenbaum NE Goldfrank LR Hoffman RS . \u00a0eds. Methemoglobin inducers in toxicologic emergencies. New York: McGraw-Hill Publishers, 2006."},{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.3","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e318187c4b1"},{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-475X.2010.00665.x"},{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.5","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1Q139"},{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2009.10.019"},{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.7","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.74.2.222"},{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2004.06.007"},{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.9","unstructured":"Drug use in Ireland and Northern Ireland. First results from the 2006\/2007 Drug Prevalence Survey. National Advisory Committee on Drugs (NACD) and Drug and Alcohol Information and Research Unit (DAIRU) January 2008. http:\/\/www.nacd.ie\/publications (accessed 9 October 2012)."},{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.10","first-page":"25","article-title":"Use of club drugs by HIV-seropositive and HIV-seronegative gay and bisexual men","volume":"11","author":"Romanelli","year":"2003","journal-title":"Top HIV Med"},{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.11","doi-asserted-by":"publisher","DOI":"10.2165\/00139709-200322010-00003"},{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.12","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198901000-00021"},{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.13","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200611000-00008"},{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.14","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e318172af73"},{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.15","first-page":"856","article-title":"Near-fatal methemoglobinemia after recreational inhalation of amyl nitrite aerolsolized with a compressed gas blower","volume":"104","author":"Lin","year":"2005","journal-title":"J Formos Med Assoc"},{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.16","doi-asserted-by":"publisher","DOI":"10.1136\/emj.14.5.339"},{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(99)70167-8"},{"key":"2025082801534329000_2012.nov21_1.bcr2012007176.18","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/BF03259842","article-title":"Drug- and chemicalinduced methaemoglobinaemia. Clinical features and management","volume":"1","author":"Hall","year":"1986","journal-title":"Med Toxicol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2012-007176","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:53:49Z","timestamp":1756371229000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2012-007176"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,11,21]]},"references-count":18,"alternative-id":["10.1136\/bcr-2012-007176"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2012-007176","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2012,11,21]]}}}