Audio By Carbonatix
A 25-year-old woman walked into an emergency department in Providence, Rhode Island, complaining of generalized weakness, fatigue, shortness of breath... and an unusual symptom you don't see every day.
She was turning blue. Literally.
Drs. Otis Warren and Benjamin Blackwood wrote about the case in a study published in the New England Journal of Medicine on Thursday. Their patient, they wrote, looked "cyanotic," the clinical term for appearing blue.
They attributed her blueness to a numbing agent the woman was using, which deadens nerve endings in the skin.
"She reported having used large amounts of topical benzocaine the night before for a toothache," the two co-authors wrote.
Warren, an emergency medicine physician at Miriam Hospital in Providence, told CNN he'd only ever seen one other "blue" patient while completing his residency. It stuck with him, so he was immediately able to identify the woman's condition.
"It's one of those rare cases that we're taught about, you study for, you take tests on, but you rarely ever see," he told CNN.
Her condition kept blood from tissue
Warren diagnosed her with "acquired methemoglobinemia," a reaction caused by certain medicines that stops blood from carrying oxygen to tissue, he said.
Oxygen-rich blood is typically associated with a bright-red color. But even though blood appears blue in patients with methemoglobinemia, oxygen levels are actually quite high, Warren said.
Blood "selfishly binds" with oxygen and doesn't release it to the tissue where it's needed. And thus, the patient appears blue.
It's fitting that the antidote is a brilliant blue, too. Methylene blue returns a missing electron to the hemoglobin molecule that restores oxygen levels and helps release oxygen back into tissue, he said.
"In my field, emergency medicine, when you can cure a patient with a single antidote--that's a rare thing for us," he said.
Numbing medication caused her reaction
In his patient's case, her reaction was caused by benzocaine, an active ingredient found in over-the-counter toothache and cold sore medicine. And while hers is a rare side effect, it warranted a warning from the Food and Drug Administration, which cautioned against its use in children under 2, who sometimes take the medicine to soothe teething pain.
Warren's patient recovered after two doses of methylene blue and an overnight stay at the hospital. But when levels of the mutated blood rise 50% or higher, patients can enter a coma or develop heart and brain complications from the lack of blood to tissue. Any amount over 60% can cause death, he said.
Latest Stories
-
Central University suspends SRC Week activities as NACOC investigates alleged cannabis trade on campus
14 minutes -
Obuasi youth petition AngloGold Ashanti over alleged neglect of sports facilities
18 minutes -
Finally, someone is looking out for us!
23 minutes -
Tradition must serve people, not prevent progress
26 minutes -
Dean Hayes Memorial International Championship set for Accra on Saturday
41 minutes -
Useless Column: Armpit dreadlocks
48 minutes -
Ghana needs GH¢1.5bn to tackle food glut as storage crisis deepens – Agric Minister
50 minutes -
Chief Justice’s Black Stars visit was private, at his own expense – Judicial Service clarifies
55 minutes -
Six arrested in Tema warehouse robberies, stolen goods recovered
2 hours -
NACOC arrests 5 students at Central University campus over cannabis-laced products (Updated)
2 hours -
“There is an urgent need for renewed action against child labour in Africa”
2 hours -
Agric Minister denies rift with Finance Ministry over GH¢1.6 billion release
2 hours -
Standard Chartered celebrates 130 years of partnership and progress with clients
2 hours -
We’ve issued notices — Weija-Gbawe MCE on planned demolition exercise
2 hours -
40 regain sight through Weija-Gbawe MP’s eye care intervention
2 hours