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In our experience, in the US, the most common cause is contamination of
potable water either through fertilizer in ground water taken from privat=
e
wells, or in several instances when a defect occurs in the heating system=
 in
a house or business place )also once a school) and boiler corrosion
prevention chemicals with a heavy concentration of NaN02 ends up in the
potable water.  With the well water the victim is usually a neonate or yo=
ung
infant and he/she is the only victim in the household.
 
-----Original Message-----
From:   Pediatric Emergency Medicine Discussion List
[mailto:[log in to unmask]] On Behalf Of javier benito
Sent:   Friday, August 07, 1998 3:51 PM
To:     Multiple recipients of list PED-EM-L
Subject:        Methemoglobinemia
 
    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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The URL for the PED-EM-L Web Page is:
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