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Langferd JS, Sheikh S. An adolescent case of sulfhemoglobinemia associated with high-dose metoclopramide and N-Acetylcysteine. Ann Emerg Med. 1999;34(4):538-541
Langferd, J. S., & Sheikh, S. (1999). An adolescent case of sulfhemoglobinemia associated with high-dose metoclopramide and N-Acetylcysteine. Annals of emergency medicine, 34(4), 538-541.
Langferd, Joseph S, and Sheikh, Shahid. "An adolescent case of sulfhemoglobinemia associated with high-dose metoclopramide and N-Acetylcysteine." Annals of emergency medicine vol. 34,4 (1999): 538-541.
Langferd JS, Sheikh S. An adolescent case of sulfhemoglobinemia associated with high-dose metoclopramide and N-Acetylcysteine. Ann Emerg Med. 1999 Oct;34(4):538-541. PMID: 28140071.
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Ann Emerg Med. 1999 Oct;34(4):538-541.

An adolescent case of sulfhemoglobinemia associated with high-dose metoclopramide and N-Acetylcysteine.

Annals of emergency medicine

Joseph S Langferd, Shahid Sheikh

Affiliations

  1. Department of Emergency Medicine University of Louisville, Louisville, KY. USA.
  2. Pediatric Pulmonary Division, Department of Pediatrics, University of Louisville, Louisville, KY. USA.

PMID: 28140071

Abstract

We describe the case of an adolescent girl who received high-dose metoclopramide in combination with oral N-acetylcysteine therapy for acute acetaminophen toxicity. Whole blood-sample analysis for abnormal hemoglobin pigments established the diagnosis of sulfhemoglobinemia. Metoclopramide has been shown to cause sulfhemoglobinemia, particularly when used in repeated high doses. Although N-acetylcysteine alone has not been associated as the cause, we suggest that sulfhemoglobinemia is a potential complication in patients treated with metoclopramide for the nausea that often accompanies oral N-acetylcysteine therapy for acetaminophen toxicity. Cyanosis without respiratory distress should suggest this diagnosis.

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