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B. Scott Teunis, MD; Ezalia I. Leftwich, MD; Lawrence E. Pierce, MD

AMA Arch Surg. 1970;101(4):527-531.

Abstract
Methemoglobinemia and severe self-limiting hemolytic anemia due to glucose-6-phosphate dehydrogenase (G-6-PD) deficiency appeared after intravenous use of toluidine blue to visualize parathyroid tissue during subtotal thyroidectomy. Determination of G-6-PD should be a part of the patient's preoperative baseline laboratory study when the use of toluidine blue is contemplated. If deficiency is documented, the drug should be administered only in an extraordinary circumstance and after adequate preparation to project the susceptible patient.

Author Affiliations
Washington, DC

From the departments of surgery (Dr. Teunis) and medicine (Drs. Leftwich and Pierce), Washington Hospital Center, Washington, DC.

Footnotes
Accepted for publication April 15, 1970.

Reprint requests to 110 Irving St NW, Washington, DC 20010 (Dr. Pierce).

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