ArticleAME case reports2026
Rebound paediatric methemoglobinemia from nitroethane ingestion: a case report.
Article in AME case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Methemoglobinemia is a potentially life-threatening hematologic condition characterized by the oxidation of hemoglobin iron, which impairs oxygen delivery. While acquired methemoglobinemia in children is commonly associated with direct oxidizing agents, accidental ingestion of industrial solvents like nitroethane presents unique management challenges. Nitroethane, found in products such as paint hardeners, metabolizes into nitrites, causing potent oxidative stress. Unlike many other causes, nitroethane ingestion is specifically associated with "rebound" methemoglobinemia due to the toxin's continued metabolism and the relatively short half-life of the antidote, methylene blue. Case Description: We report the case of a 6-year-old boy who presented with vomiting, abdominal pain, and progressive central cyanosis following the accidental ingestion of a mouthful of paint chemical hardener (AkzoNobel) that had been stored in a reused drinking water bottle. Upon arrival, he exhibited cyanosis refractory to high-flow oxygen, with oxygen saturation (SpO Conclusions: This case illustrates the severe toxicity of small volume nitroethane ingestion and highlights the critical risk of rebound methemoglobinemia. Because the oxidative effects of nitroethane metabolites can outlast the therapeutic duration of methylene blue, a single dose of antidote is often insufficient. Clinicians must ensure prolonged observation and serial co-oximetry monitoring for these patients. Furthermore, this case underscores the vital public health need for keeping hazardous chemicals in original, child-resistant containers to prevent accidental pediatric poisonings.
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