Severe chronic Carboxyhemoglobinemia and polycythemia due to smoking hookah

Hiba Anaqrah; Daniel J McCabe

doi:10.1016/j.ajem.2021.12.050

Back

Severe chronic Carboxyhemoglobinemia and polycythemia due to smoking hookah

Journal article

Peer reviewed

Severe chronic Carboxyhemoglobinemia and polycythemia due to smoking hookah

Hiba Anaqrah and Daniel J McCabe

The American journal of emergency medicine, Vol.55, pp.226.e1-226.e2

05/2022

DOI: 10.1016/j.ajem.2021.12.050

PMID: 34974952

View Online

Abstract

Acute carbon monoxide (CO) poisoning due to smoking hookah has been reported and may present similarly to other causes of acute carbon monoxide poisoning with nausea, headache, and loss of consciousness [1]. In the acute poisoned patient, immediate removal from the carbon monoxide source is paramount in addition to administration of oxygen and possible hyperbaric oxygen therapy (HBO) in certain situations. However, cases of chronic CO poisoning, treatment options, and long-term adverse health effects are far less reported but may include atherosclerosis and vague neurologic symptoms [2]. We present a case of a patient who chronically smoked hookah creating a condition of chronic carboxyhemoglobinemia which was discovered during work up for unexplained polycythemia. While being seen in the hematology clinic, he was found to have a blood carboxyhemoglobin of level 33.6% despite being asymptomatic. This is the highest recorded hookah-related carboxyhemoglobin concentration in the medical literature; and the significant chronic carboxyhemoglobinemia explained his polycythemia. This case illustrates that a social history is crucial when assessing the patient with severe carboxyhemoglobinemia as HBO is not indicated in chronic CO poisoning in an asymptomatic patient.

Carbon Monoxide

Carbon Monoxide Poisoning - complications

Carbon Monoxide Poisoning - therapy

Carboxyhemoglobin

Humans

Hyperbaric Oxygenation

Male

Polycythemia - complications

Polycythemia - therapy

Smoking

Smoking Water Pipes

Details

Title: Subtitle: Severe chronic Carboxyhemoglobinemia and polycythemia due to smoking hookah
Creators: Hiba Anaqrah - University of Iowa
Daniel J McCabe - University of Iowa
Resource Type: Journal article
Publication Details: The American journal of emergency medicine, Vol.55, pp.226.e1-226.e2
DOI: 10.1016/j.ajem.2021.12.050
PMID: 34974952
ISSN: 0735-6757
eISSN: 1532-8171
Language: English
Date published: 05/2022
Academic Unit: Emergency Medicine
Record Identifier: 9984297148602771

Metrics

21 Record Views

4 Times Cited - Web of Science

See more details