Pediatria pre prax 1/2014

Alimentary methaemoglobinemia

The preparation of feeding formula by using of nitrates contaminated water is well-known risk factor of methaemoglobinemia in infants. Increased oxidability of fetal haemoglobin and also relativelly low activity of methemoglobin-reductase increase susceptibility of small infants to oxidative agents. Sick child can have gray cyanosis, dyspnoea, tachycardia, it can be irritating or letargic depends on severity of the condition. It is characteristic that course of disease is not improving by oxygen supply. In our case report we describe fatal course of alimentary methaemoglobinemia in one small infant and also short summary of three others cases of alimentary methaemoglobinemia. All of these four patients were hospitalized on the Ward of paediatric intensive care of 3rd Paediatric Department in Hospital in Lucenec during one year. This is serious epidemiological fact because incidence of cases in this region is well above average incidence of alimentary methaemoglobinemia in our country. On the base of our experience we want to show that the course od disease can progress rapidly to multiorgan failure with fatal outcome if it is not early detected and adequate treated.

Keywords: methemoglobin, alimentary methaemoglobinemia in infants, nitrates in sources of drinking water, antidote - methylene blue, toluidine blue.