Crisis aguda de cianosis en un lactante / Acute cyanotic episode in an infant

RESUMEN

La metahemoglobinemia es una causa de cianosis poco frecuente en la edad pediátrica, debida a la exposición a agentes oxidantes de la hemoglobina, como los nitratos, presentes en el agua o verduras (espinacas, acelgas, zanahorias, calabacín y judías verdes).La metahemoglobinemia asociada a alimentos infantiles ricos en nitratos ha sido descrita frecuentemente. El consumo de puré de verduras conservado deficientemente es una causa potencial de metahemoglobinemia infantil adquirida. Los lactantes de menos de 6 meses de edad son particularmente susceptibles a padecer esta entidad. Presentamos el caso de un lactante de 9 meses, traído al Servicio de Urgencias con cianosis central tras la ingesta de un puré de verduras preparado de forma casera y conservado en nevera durante más de 48 horas. El porcentaje de metahemoglobina determinado por cooximetría fue del12,1%. El cuadro se resolvió completamente en 6 horas sin precisar tratamiento con azul de metileno (AU)

ABSTRACT

Methemoglobinemia is a rare cause of cyanosis in paediatricage due to the exposure to haemoglobin-oxidizingagents such as nitrates present in well water or vegetables(spinach, beets, carrots, courgette and green beans).Methemoglobinemia associated with high-nitrate infant food has been reported frequently. Consumption of vegetable puree with an incorrect storage is a potential cause of acquired infantile methemoglobinemia. Infants younger than 6 months old are particularly susceptible to this condition. We report a case of a 9-month-old male infant who was brought to the paediatric emergency department with central cyanosis after eating a homemade mixed vegetable puree prepared in advance and stored in the refrigerator longer than 48 hours. His methemoglobin level determined by cooximetry was12.1%. After 6 hours, the syndrome was completely resolved without needing methylene blue treatment (AU)