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5018121 
Journal Article 
Naphthalene toxicity: Methemoglobinemia and acute intravascular hemolysis 
Volney, G; Tatusov, M; Yen, AC; Karamyan, N 
2018 
Cureus
ISSN: 2168-8184 
10 
e3147 
English 
Naphthalene poisoning is a rare form of toxicity that may occur after ingestion, inhalation, or dermal exposure to naphthalene-containing compounds such as mothballs. Clinically, patients present with acute onset of dark brown urine, watery diarrhea, and non-bloody bilious vomiting 48-96 hours after exposure. Vital sign abnormalities include fever, tachycardia, hypotension, and persistent pulse oximetry readings of 84%-85% despite oxygen supplementation. Laboratory workup demonstrates hyperbilirubinemia with indirect predominance, hemolytic anemia, methemoglobinemia, and renal dysfunction. Treatment options include supportive care, red cell transfusion, ascorbic acid, methylene blue, and N-acetylcysteine. We present a case of naphthalene toxicity in a 20-year-old autistic male, who improved with supportive care, red blood cell transfusion, and ascorbic acid. 
IRIS
• Naphthalene
     Database Searches
          PubMed
     Combined data set
          Data set for title/abstract screening
               Data set for full text review
                    Excluded – PECO criteria not met (full-text)
     Supplemental material
          Case reports/Case series
          Mechanistic
               Mechanisms of hemolysis
     Feb 2019 Update
          PubMed
Other
• Naphthalene (2021 Evidence mapping publication)
     Database Searches
          PubMed
     Combined data set
          Data set for title/abstract screening
               Data set for full text review
                    Excluded – PECO criteria not met (full-text)
     Supplemental material
          Case reports/Case series
          Mechanistic
               Mechanisms of hemolysis
     Feb 2019 Update
          PubMed