DOI: 10.12890/2014_000139

Use of Poppers (Amyl Nitrite): Unpleasant Side Effects in a Brothel

Authors

  • Thomas Kofler Department of Internal Medicine, University Hospital Basel, Basel Cardiovascular Research Institute Basel, University Hospital Basel, Basel
  • Kriemhild Lippay Emergency Department, University Hospital Basel, Basel
  • Marlon Goekcimen Emergency Department, University Hospital Basel, Basel
  • Dominique Fasel Emergency Department, University Hospital Basel, Basel
  • Christian H. Nickel Emergency Department, University Hospital Basel, Basel

thomas.kofler@usb.ch

Abstract

Introduction: Various agents can lead to an acquired methaemoglobinaemia (MHB) with potentially fatal consequences. There is a lack of literature on the formation of methaemoglobin (MH) in the blood after the intake of poppers (amyl nitrite). Poppers are a popular aphrodisiac agent.
Case description: A 56-year-old diabetic called an ambulance after using poppers in a brothel with subsequent associated acrocyanosis, confusion and headache. The paramedics reported tachycardia and blood glucose of 3.8 mmol/l. The arterial blood gas analysis in the Emergency Department (ED) revealed a MHB of 23.1%. MH levels decreased rapidly without antidotal therapy. The patient was discharged the next day free of symptoms.
Discussion: This case illustrates the potential risks of taking poppers. A wide spectrum of symptoms were present in our patient. For the differential diagnosis of acquired MHB, poppers should be considered.

View the entire article

Downloads

References

  1. Wright RO, Lewander WJ, Woolf AD. Methemoglobinemia: etiology, pharmacology, and clinical management, Ann Emerg Med 1999;34:646–656.
  2. Chilcote RR, Williams B, Wolff LJ, Baehner RL. Sudden death in an infant from methemoglobinemia after administration of 'sweet spirits of nitre', Pediatrics 1977;59:280–282.
  3. Faley B, Chase H. A case of severe amyl nitrite induced methemoglobinemia managed with methylene blue, J Clin Toxicol [Internet] 2012;2:127
  4. Sohn CH, Seo DW, Ryoo SM, Lee JH, Kim WY, Lim KS, Oh BJ. Life-threatening methemoglobinemia after unintentional ingestion of antifreeze admixtures containing sodium nitrite in the construction sites, Clin Toxicol (Phila) 2014;52:44–47.
  5. Askew GL, Finelli L, Genese CA, Sorhage FE, Sosin DM, Spitalny KC. Boilerbaisse: an outbreak of methemoglobinemia in New Jersey in 1992, Pediatrics 1994;94:381–384.
  6. Staïkowsky F, Perret A, Péviriéri F, Zanker C, Zerkak D, Pelloux P, Danhiez F. [Poisoning with 'poppers', a rare cause of methemoglobinemia observed in emergency cases], Presse Med 1997;26:1381–1384.
  7. Stambach T, Haire K, Soni N, Booth J. Saturday night blue: a case of near fatal poisoning from the abuse of amyl nitrite, J Accid Emerg Med 1997;14:339–340.
  8. Modarai B, Kapadia YK, Kerins M, Terris J. Methylene blue: a treatment for severe methaemoglobinaemia secondary to misuse of amyl nitrite, Emerg Med J 2002;19:270–271.
  9. Jørgensen KA, Lawesson SO. Amyl nitrite and Kaposi’s sarcoma in homosexual men, N Engl J Med 1982;307:893–894.
  10. Lycka B. Amyl and butyl nitrites and telangiectasia in homosexual men, Ann Intern Med 1987;106:476.
  11. McManus TJ, Starrett LA, Harris JR. Amyl nitrite use by homosexuals, Lancet 1982;1:503.
  12. Machabert R, Testud F, Descotes J. Methaemoglobinaemia due to amyl nitrite inhalation: a case report, Hum Exp Toxicol 1994;13:313–314.
  13. Moos M, Schröder R, Lang M, Frauchiger B. Schwere Methämoglobinämie: Diagnostik, Therapie und Pathophysiologie am Beispiel eines Falles, Anästhesiol Intensivmed Notfallmedizin Schmerzther 2009;44:328–334.
  14. Wellershoff G. Potenziell letale Methämoglobinämie nach Ingestion von Alkylnitriten („Poppers“), Notfall+Rettungsmedizin 2014;17:137–140.
  15. Nkwugbukansi O. Methemoglobinemia: pathology, endogenous reductions and clinical management, Int J Biosci Biotechnol Res 2014;1:1–14.
  16. Rosen PJ, Johnson C, McGehee WG, Beutler E. Failure of methylene blue treatment in toxic methemoglobinemia: association with glucose-6-phosphate dehydrogenase deficiency, Ann Intern Med 1971;75:83–86.

Published

2014-11-05

How to Cite

1.
Kofler T, Lippay K, Goekcimen M, Fasel D, Nickel CH. Use of Poppers (Amyl Nitrite): Unpleasant Side Effects in a Brothel. EJCRIM [Internet]. 2014 Nov. 5 [cited 2026 Nov. 3];1(1). Available from: https://ejcrim.com/index.php/ejcrim/article/view/139