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    The most frequent oxidative agent which produce acquired
methemoglobinemia in my practice is the enhance contents of nitrates in
vegetables from unsuitable manure soil. This kind of methemoglobinemia
usually causes minimal clinical problems (range < 30%). In most cases,
is not necesary to determinate the level of nitrates in blood or
vegetables to confirm the presumptive diagnosis. However it's very easy
to colect a urine specimen and performed a dipstick test for nitrites.
In the last three cases of methemoglobinemia presumptively caused for
vegetables that we attended in our emergency room, the disptick test for
nitrites was positive. Although this fact don=B4t change the treatment I
think it helps to eliminate another causes of methemoglobinemia.
 
    I'd like to know other opinions. Thaks for your help. Javier Benito.
Hospital Cruces. Bilbao. Spain.
 
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