Hemolytic anemia after methylene blue therapy for aniline-induced methemoglobinemia

Vet Hum Toxicol. 2002 Feb;44(1):19-21.


Methylene blue is utilized as the main treatment of methemoglobinemia conventionally, but it may be ineffective in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. We report a G6PD-deficient patient who suffered from aniline-induced methemoglobinemia with initial good response Heinz body but hemolytic anemia appeared later 3 d after methylene blue therapy. G6PD deficiency was identified. He recovered uneventfully with hydration, packed blood transfusion and adjuvant luvela-N(dl-alpha-tocopheryl nicotinate) medication. Caution should be taken in using methylene blue as antidote of acute methemoglobinemia, especially when a history of G6PD deficiency is obscure.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anemia, Hemolytic / chemically induced*
  • Anemia, Hemolytic / physiopathology
  • Aniline Compounds / poisoning*
  • Carcinogens
  • Enzyme Inhibitors / adverse effects*
  • Enzyme Inhibitors / therapeutic use
  • Glucosephosphate Dehydrogenase Deficiency*
  • Humans
  • Male
  • Methemoglobinemia / chemically induced*
  • Methemoglobinemia / drug therapy
  • Methylene Blue / adverse effects*
  • Methylene Blue / therapeutic use
  • Occupational Exposure


  • Aniline Compounds
  • Carcinogens
  • Enzyme Inhibitors
  • aniline
  • Methylene Blue