Methemoglobinemia: nitrate toxicity in rural America
- University of Iowa College of Medicine, Iowa City (United States)
Nitrates are frequently found in vegetables and ground water. Nitrate levels in ground water have increased over the past two decades because of the heightened use of nitrogenous fertilizers. Following ingestion, nitrates are converted to nitrites by fecal organisms. Nitrites are absorbed and form methemoglobin, which interferes with the oxygen-carrying capacity of hemoglobin. Infants are particularly susceptible to nitrate poisoning because fetal hemoglobin is more readily oxidized to methemoglobin. In infants, the most common source of nitrate exposure is well water, which is mixed with infant formula. Affected infants may present with asymptomatic cyanosis, which can progress to dyspnea and lethargy or coma. Blood methemoglobin concentrations are elevated. Treatment consists of the administration of oxygen and intravenous and oral methylene blue.24 references.
- OSTI ID:
- 7287864
- Journal Information:
- American Family Physician; (United States), Vol. 46:1; ISSN 0002-838X
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
METHEMOGLOBIN
BIOSYNTHESIS
NITRATES
TOXICITY
AGE DEPENDENCE
HEMIC DISEASES
INGESTION
MAN
RURAL AREAS
WATER SUPPLY
ANIMALS
CARBOXYLIC ACIDS
DISEASES
GLOBINS
HEMOGLOBIN
HETEROCYCLIC ACIDS
HETEROCYCLIC COMPOUNDS
INTAKE
MAMMALS
NITROGEN COMPOUNDS
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
OXYGEN COMPOUNDS
PIGMENTS
PORPHYRINS
PRIMATES
PROTEINS
SYNTHESIS
VERTEBRATES
560300* - Chemicals Metabolism & Toxicology