{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:40:06Z","timestamp":1756327206454,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,4,11]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>Methaemoglobin is an altered state of haemoglobin wherein the iron moiety of haemoglobin is oxidised from its ferrous (Fe2+) to ferric (Fe3+) form. Methaemoglobinaemia is a condition characterised by increased methaemoglobin concentration in the blood that is greater than 1%. It is a potentially life-threatening condition as methaemoglobin hinders the delivery of oxygen to tissues, leading to hypoxia and tissue damage. Here we report a case of methaemoglobinaemia induced by self-poisoning with a plant growth promoter in India, which contained only organic substances and was free of any toxic substance. Prompt clinical suspicion and evaluation are critical to identify acquired methaemoglobinaemia because the condition is rare but potentially life-threatening. To summarise, methaemoglobinaemia is to be suspected with low oxygen saturation that does not improve on oxygen supplementation, disparity between spO2 and pO2 and chocolate brown coloured blood. It is treated with methylene blue, which reduces methaemoglobin to haemoglobin.<\/jats:p>","DOI":"10.1136\/bcr-2024-264618","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T04:15:22Z","timestamp":1745554522000},"page":"e264618","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Acquired methaemoglobinaemia induced by ingestion of plant growth promoter"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5741-5803","authenticated-orcid":false,"given":"Naren Karthik","family":"Sakthi Saravanan","sequence":"first","affiliation":[{"name":"Coimbatore Medical College and Hospital, Coimbatore, India"},{"name":"Department of Emergency Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanishka","family":"Manikandan","sequence":"additional","affiliation":[{"name":"Coimbatore Medical College and Hospital, Coimbatore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,4,24]]},"reference":[{"key":"2025082713130172000_18.4.e264618.1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-045182","article-title":"Toxicoepidemiology of poisoning exhibited in Indian population from 2010 to 2020: a systematic review and meta-analysis","volume":"11","author":"Mittal","year":"2021","journal-title":"BMJ Open"},{"key":"2025082713130172000_18.4.e264618.2","doi-asserted-by":"crossref","first-page":"4160","DOI":"10.4103\/jfmpc.jfmpc_518_21","article-title":"Study of organophosphorus compound poisoning in a tertiary care hospital and the role of Peradeniya Organophosphorus Poisoning scale as a prognostic marker of the outcome","volume":"10","author":"Kamath","year":"2021","journal-title":"J Family Med Prim Care"},{"key":"2025082713130172000_18.4.e264618.3","doi-asserted-by":"crossref","first-page":"394","DOI":"10.2165\/00002018-199614060-00005","article-title":"Drug-induced methaemoglobinaemia","volume":"14","author":"Coleman","year":"1996","journal-title":"Treatment Issues Drug Saf"},{"key":"2025082713130172000_18.4.e264618.4","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000141096.00377.3f"},{"key":"2025082713130172000_18.4.e264618.5","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1056\/NEJM196811212792102","article-title":"Methemoglobinemia provoked by malarial chemoprophylaxis in Vietnam","volume":"279","author":"Cohen","year":"1968","journal-title":"N Engl J Med"},{"key":"2025082713130172000_18.4.e264618.6","doi-asserted-by":"crossref","first-page":"e886","DOI":"10.1097\/MPH.0000000000001979","article-title":"Rasburicase-induced Methemoglobinemia: A Case Report and Literature Review","volume":"43","author":"Pirrone","year":"2021","journal-title":"J Pediatr Hematol Oncol"},{"key":"2025082713130172000_18.4.e264618.7","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1080\/15563650.2022.2061986","article-title":"Acquired methemoglobinemia in children presenting to Italian pediatric emergency departments: a multicenter report","volume":"60","author":"Raucci","year":"2022","journal-title":"Clin Toxicol (Phila)"},{"key":"2025082713130172000_18.4.e264618.8","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1080\/15563650.2019.1657883","article-title":"Methemoglobinemia associated with massive acetaminophen ingestion: a case series","volume":"58","author":"Rianprakaisang","year":"2020","journal-title":"Clin Toxicol (Phila)"},{"key":"2025082713130172000_18.4.e264618.9","doi-asserted-by":"crossref","first-page":"113","DOI":"10.4103\/0972-5229.126087","article-title":"Severe methemoglobinemia due to insecticide poisoning","volume":"18","author":"George","year":"2014","journal-title":"Indian J Crit Care Med"},{"key":"2025082713130172000_18.4.e264618.10","unstructured":"Sulfath TS , Bhanu Kumar M , Koneru V . Case report on methylene blue induced hemolytic anemia."},{"key":"2025082713130172000_18.4.e264618.11","doi-asserted-by":"crossref","first-page":"253","DOI":"10.4103\/0972-5229.130582","article-title":"Methylene blue unresponsive methemoglobinemia","volume":"18","author":"Patnaik","year":"2014","journal-title":"Indian J Crit Care Med"},{"key":"2025082713130172000_18.4.e264618.12","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.jemermed.2017.04.036","article-title":"A Case of Methemoglobinemia Successfully Treated with Hyperbaric Oxygenation Monotherapy","volume":"53","author":"Cho","year":"2017","journal-title":"J Emerg Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-264618","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:13:08Z","timestamp":1756325588000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-264618"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":12,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4,24]]},"published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1136\/bcr-2024-264618"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-264618","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}