Naphthalene Induced Acute Hemolysis in A G6PD Deficient Bangladeshi Boy - A Case Report

Naphthalene (C10 H8) is a bicyclic aromatic hydrocarbon having 128 molecular weight [1]. Usually it is used as a deodorant in lavatories, moth repellent and as insecticides, mite powders and vermifuges [2]. In Bangladesh, a developing country, naphthalene is very popular and widely used moth repellent. People use it freely in household as it is very cheap and easily available. Naphthalene is marketed commercially in the form of various attractive shapes like balls, flakes, stars etc and its sparkling bright white colour is also very appealing to children. So, exposure can easily occur to them through inhalation, dermal absorption or ingestion and may cause severe toxicities like severe Hemolysis. But most of the people are unaware about its hazards. The characteristic signs of naphthalene toxicities are headache, vomiting, diarrhea, abdominal pain, fever, altered mental status and consequences of acute intravascular Hemolysis leading to anemia, leukocytosis, hematuria, jaundice and liver and kidney dysfunction [1]. Cerebral oedema, confusion, convulsion, coma and death may occur [3]. Commercially available one mothball contains 0.5-5 gm of naphthalene depending upon its size. The lethal dose of ingested naphthalene is 2 grams in children and in adults 5-15 grams [4]. But small naphthalene mothball ingestion may be very dangerous and potentially lethal for the G6PD deficient individuals [5]. Vales et al. [6] reported 21 neonates who developed Hemolysis after exposure to naphthalene, 12 of them were diagnosed as G6PD deficiency disorder. So, it should be our concern to aware people about the hazards of naphthalene, especially in G6PD deficient individual.