In this patient, syncope was likely a result of hypoxia attributable to MetHb and the hypotensive effects of the butyl nitrite. The MetHb value was obtained ~60 min after the patient's syncopal episode.
Methemoglobinemia from sniffing butyl nitrite. Ann Intern Med 1979;91:417-8.
Furthermore, studies of HIV seroconversion among older, non-monogamous gay men have found an association between unprotected receptive anal sex and the use of amyl and
butyl nitrites, rather than data that support Rotello's assertion that the total number of sexual partners is predictive of seroconversion (Ostrow, Beltran, Joseph, DiFranceisco, Wesch, & Chmiel, 1993).