Methylthioninium chloride injection

A 59-year-old man had 6 ml of unbuffered methylthioninium chloride injected into the lumbar theca in an attempt to localize the source of cerebrospinal fluid rhinorrhea (18). After injection of the dye he became shocked, and within the next few days developed a mild paraparesis, which subsequently progressed to total paraplegia. 

Multiple ileal occlusions have been reported in babies born to mothers who had twin pregnancies and who had received methylthioninium chloride administered during amniocentesis (10-12). In a number of cases it was found that methylthioninium chloride had been injected into the amniotic sac of the affected twins. 

A 2.5-month-old boy developed cyanosis on his lips and entire body 15 minutes after circumcision, during which prilocaine hydrochloride 30 mg had been injected subcutaneously [71 ]. The cyanosis resolved after a single intravenous dose of ascorbic acid (vitamin C) 300mg/kg methylthioninium chloride was not available. 

Methylene blue, or methylthioninium chloride, is a thiazine dye (Fig. 7.22, Table 7.13) unrelated in structure to patent blue V and isosulfan blue. Although not always approved for the purpose, methylene blue has been used for sentinel lymph node localization. Because it can cause necrosis on subcutaneous injection, it is generally... 

Skin Methylthioninium chloride has been used for lymphatic mapping/sentinel lymphadenectomy in staging melanoma and breast cancer. It can cause skin necrosis, but more mild adverse reactions from intraparenchymal breast injection are not well characterized. Of patients undergoing staging for breast cancer and melanoma, 95 received intraparenchymal breast injected of methylthioninium chloride [65 ]. 

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