Sumatriptan-induced sulfhaemoglobinaemia
admin June 9th, 2007
The Lancet [registration required] reports on a case of sumatriptan-induced sulfhaemoglobinaemia:
In October, 2005, a 42-year-old man presented to our hospital, having developed a compartment syndrome in both lower legs. He was a smoker; his medical history included migraine. His regular medications were sumatriptan, which he had been taking at a dose of 200 mg per day, for several months, diclofenac, and zopiclone.
[...]
several attempts to insert an indwelling radial-arterial catheter yielded dark, greenish-black blood. Eventually, the catheter was advanced, and pressure transduction confirmed arterial placement. The displayed SpO2 was 96% on supplemental oxygen (inspired oxygen fraction [FIO2], 0.5). A sample of the greenish-black blood was sent to the laboratory for co-oximetry. The oxygen saturation (SaO2) was 94%, and the oxygen partial pressure (PaO2) 135 mm Hg. The methaemoglobin concentration was within the normal range, at 1·17 g/L (0·9%), as was the carboxyhaemoglobin concentation—but the analyzer displayed an alert to the presence of sulfhaemoglobin. Quantitative analysis (Beckman DU65 Spectrophotometer, Beckman Coulter, Mississauga, Canada) revealed a sulfhaemoglobin concentration of 2 g/L. The patient recovered uneventfully, and stopped taking sumatriptan after discharge. When seen 5 weeks after his last dose, he was found to have no sulfhaemoglobin in his blood.
M Flexman A, Del Vicario G, Schwarz SKW. Dark green blood in the operating theatre. The Lancet 2007; 369: 1972
The BBC also reports on the story.