Central cyanosis on a psychiatric unit treated at the Salford Royal Hospital

Thorax. 2014 Dec;69(12):1157-8. doi: 10.1136/thoraxjnl-2014-205769. Epub 2014 Jul 25.

Abstract

We describe a case of acquired methaemoglobinaemia due to frequent use of the 'legal high' known as 'Pink Panthers'. This contains 5,6-Methylenedioxy-2-aminoindane and 2-Aminoindane, both amphetamine analogues with the potential to cause methaemoglobinaemia. Furthermore, the most common 'cutting agent' for legal highs in the UK is benzocaine, also known to cause methaemoglobinaemia. Given the increasing prevalence of legal highs, particularly those containing added benzocaine, such presentations may become more common. Furthermore, in one case series, benzocaine gel used for toothache was the second most common reason for hospitalisation due to acquired methaemoglobinaemia after dapsone use. Indeed, the Federal Drug Agency has issued as public warning as to the risk of these products. We therefore think that clinicians and the public should be made more aware of the risk associated with such agents.

Keywords: Clinical Epidemiology; Drug Reactions.

Publication types

  • Case Reports

MeSH terms

  • Benzocaine / adverse effects
  • Cyanosis / chemically induced*
  • Humans
  • Illicit Drugs / adverse effects
  • Indans / adverse effects*
  • Methemoglobinemia / chemically induced*
  • Methemoglobinemia / diagnosis
  • Schizophrenic Psychology
  • Substance-Related Disorders / complications*
  • Substance-Related Disorders / diagnosis

Substances

  • Illicit Drugs
  • Indans
  • 5,6-methylenedioxy-2-aminoindane
  • 2-aminoindan
  • Benzocaine