Hemolytic anemia presenting as hemoglobinuria from intentional paradichlorobenzene mothball ingestion

Abstract

A 24-year-old Filipino male was diagnosed with hemolytic anemia when he presented with abrupt onset of anemia, hemoglobinuria, and increased bilirubins, after intentionally ingesting mothballs containing paradichlorobenzene. He was transfused with six units of packed red blood cells (PRBC) and was discharged improved. Paradichlorobenzene, a known oxidant, causes denaturation and precipitation of hemoglobin. These precipitates form Heinz bodies within the erythrocytes that are removed by the reticuloendothelial system, fragmenting cells to produce hemolysis. This is the first reported case in the Philippines of hemolytic anemia from paradicholorobenzene ingestion as confirmed by the UP-National Poison Management and Control Center.