[Methaemoglobinaemia in a child treated with Emla(®) cream: circumstances and consequences of overdose]. / Méthémoglobinémie après application de crème Emla(®) chez un enfant : circonstances et conséquences d'un surdosage.

BACKGROUND: Emla(®) cream, a mixture of two local anaesthetics (prilocaine 2.5%, lidocaine 2.5%) has a good benefit-risk profile. However, methaemoglobinaemia can occur, especially when the cream is applied in excessive amounts or over long periods. PATIENTS AND METHODS: The authors report a case of seizure and respiratory disturbances (MetHb=20.1%) after excessive application of Emla(®) (30g) for curettage of molluscum contagiosum in a young girl with eczema. The patient's clinical condition improved after withdrawal of the cream and administration of methylene blue, and she returned home on day two. DISCUSSION: This new case of methaemoglobinaemia in a child following application of Emla(®) cream highlights the importance of strict compliance with the instructions for use of this medicinal product.

[Hemolytic anemia after voluntary ingestion of henna (Lawsonia inermis) decoction by a young girl with G6PD deficiency]. / Ingestion volontaire de decoction de henné (Lawsonia inermis) d'un déficit en G6PD.

Henna (Lawsonia inermis) is a shrub bearing leaves that are crushed and used for cosmetic purposes in Asia and Africa. In several countries, henna decoction is ingested as a traditional drug to induce abortion. One component of Henna, known as Lawsone, can induce hemolysis in G6PD-deficient patients after cutaneous exposure or ingestion. The purpose of this report is to describe a case of severe hemolytic anemia after voluntary ingestion of Henna decoction to induce abortion. This complication led to diagnosis of partial moderate G6PD-deficiency in the 17-year-old patient living in Mayotte in the Indian Ocean. This report emphasizes the life-threatening hazards associated with some plant extracts used as traditional medicines.

[Occurrence of severe cardiac alterations in Amanita proxima poisoning: two original observations]. / Survenue d'une atteinte cardiaque sévère au cours du syndrome proximien : deux observations originales.

Amanita proxima is one species of white mushroom which can induce poisonings called in France "proximien" syndrome. The clinical feature of "proximien" syndrome is mainly characterized by early digestive troubles, mild hepatic cytolysis and late renal impairment. A cardiac insult has never been reported in such a circumstance. The authors describe herein two cases of white mushroom poisoning occurred in the Mediterranean French coast with a typical clinical feature of "proximien" syndrome plus secondary development of severe cardiac alterations. The outcome was good for the two patients thanks to symptomatic treatment. The cases reported here suggest that A. proxima have a potential severe cardiac toxicity leading to include early and precise cardiac examination in the management of patients poisoned by these mushrooms.