Amyl Nitrite-Induced Hemolytic Anemia: Acute Therapy and Prevention.

Amira H Elshikh,Amandeep Bawa,Jeffrey Lankowsky,Marwa Baalbaki,Ghazal Kango

doi:10.7759/cureus.16099

Abstract

Inhaled nitrites have been a substance of recreational use for centuries, primarily among men who have sex with men (MSM). However, there is a lack of awareness of the use of inhaled nitrites in this population and the possible complications and health disparities it carries. In this case report, we present a 62-year-old man with a past medical history of glucose-6 phosphate dehydrogenase (G6PD) deficiency presenting with severe hemolytic anemia and methemoglobinemia after recreational use of inhaled nitrites. The case was complicated with the presence of methemoglobinemia in a patient with G6PD deficiency. This report also aims to increase awareness of the use of nitrites in the MSM population. The use of nitrites is a predictor for high-risk sexual behavior and is associated with positive human immunodeficiency virus (HIV) status.

Highlights

Inhaled nitrites, referred to as “poppers,” are substances of recreational use tracing as far back as the nineteenth century when they were used to heighten stimulation and induce muscle relaxation [1]
This case report highlights the complications seen with inhaled nitrites in the men who have sex with men (MSM) community, the challenge it poses with therapy in the glucose-6 phosphate dehydrogenase (G6PD)-deficient population, and to increase provider awareness of inhaled nitrite use and its possible consequences
Inhaled nitrites have been a substance of recreational use for centuries, primarily among men who have sex with men (MSM)

Summary

Introduction

Inhaled nitrites, referred to as “poppers,” are substances of recreational use tracing as far back as the nineteenth century when they were used to heighten stimulation and induce muscle relaxation [1]. Prior studies have shown that the use of recreational inhaled nitrites among men who identify as homosexual or bisexual was associated with an increased risk of unsafe sexual encounters and higher rates of human immunodeficiency virus (HIV) [6,7,8]. This case report highlights the complications seen with inhaled nitrites in the MSM community, the challenge it poses with therapy in the G6PD-deficient population, and to increase provider awareness of inhaled nitrite use and its possible consequences

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