Publication Name	World Journal of Critical Care Medicine
Manuscript ID	120702
DOI	10.5492/wjccm.120702
Country	India

Category	Critical Care Medicine
Manuscript Type	Case Report
Article Title	Methylene blue for treating toxic encephalopathy due to acute nickel poisoning: A case report
Manuscript Source	Invited Manuscript
All Author List	Rajathadri Hosur Ravikumar, Sayan Nath, Javed Ahsan Quadri and Sulagna Bhattacharjee
Funding Agency and Grant Number
Corresponding Author	Rajathadri Hosur Ravikumar, Assistant Professor, Department of Critical Care Medicine, Ramaiah Medical College, M S Ramaiah Nagar, Mathikere, Bengaluru, Bangalore 560054, Karnātaka, India. drrajathadri@gmail.com
Key Words	Acute nickel toxicity; Toxic encephalopathy; Methylene blue; Corrosive ingestion; Toxidrome; Case report
Core Tip	When a routine toilet cleaner ingestion caused an atypical cholinergic toxidrome and refractory vasoplegic shock, standard therapies failed. An exhaustive toxicological screen revealed acute nickel poisoning, accompanied by central nervous system metal sequestration and a unique cytotoxic lesion of the corpus callosum on brain magnetic resonance imaging. Remarkably, rescue therapy with methylene blue for the shock correlated with a paradoxical spike in urinary nickel excretion and rapid clinical recovery. While this biochemical washout mechanism remains hypothetical, the case offers a crucial clinical framework for managing rare heavy metal toxicity when standard chelators are completely unavailable.
Citation	Hosur Ravikumar R, Nath S, Quadri JA, Bhattacharjee S. Methylene blue for treating toxic encephalopathy due to acute nickel poisoning: A case report. World J Crit Care Med 2026; In press DOI: https://doi.org/10.5492/wjccm.120702
PDF	120702-in-press.pdf

Received	2026-03-06 02:21
Peer-Review Started	2026-03-06 02:21
First Decision by Editorial Office Director	2026-04-28 01:38
Return for Revision	2026-04-28 01:38
Revised	2026-05-24 08:04
Publication Fee Transferred
Second Decision by Editor	2026-06-23 02:18
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-06-23 06:54
Articles in Press	2026-06-23 06:54
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2220-3141(online)
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Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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