Methemoglobinemia

Methemoglobinemia
Other namesHemoglobin M disease,[1]
Chocolate-brown blood due to methemoglobinemia
SpecialtyToxicology, haematology
SymptomsHeadache, dizziness, shortness of breath, nausea, poor muscle coordination, blue-colored skin[2]
CausesBenzocaine, nitrites, dapsone, genetics[3]
Diagnostic methodBlood gas[3]
Differential diagnosisArgyria, sulfhemoglobinemia, heart failure[3]
TreatmentOxygen therapy, methylene blue[3]
PrognosisGenerally good with treatment[3]
FrequencyRelatively uncommon[3]

Methemoglobinemia, or methaemoglobinaemia, is a condition of elevated methemoglobin in the blood.[2] Symptoms may include headache, dizziness, shortness of breath, nausea, poor muscle coordination, and blue-colored skin (cyanosis).[2] Complications may include seizures and heart arrhythmias.[3][4]

Methemoglobinemia can be due to certain medications, chemicals, or food or it can be inherited.[2] Substances involved may include benzocaine, nitrites, or dapsone.[3] The underlying mechanism involves some of the iron in hemoglobin being converted from the ferrous [Fe2+] to the ferric [Fe3+] form.[3] The diagnosis is often suspected based on symptoms and a low blood oxygen that does not improve with oxygen therapy.[3] Diagnosis is confirmed by a blood gas.[3]

Treatment is generally with oxygen therapy and methylene blue.[3] Other treatments may include vitamin C, exchange transfusion, and hyperbaric oxygen therapy.[3] Outcomes are generally good with treatment.[3] Methemoglobinemia is relatively uncommon, with most cases being acquired rather than genetic.[3]

  1. ^ "Methemoglobinemia". MedlinePlus Medical Encyclopedia. U.S. National Library of Medicine. Retrieved 8 June 2019.
  2. ^ a b c d "NCI Dictionary of Cancer Terms". National Cancer Institute. 2 February 2011. Retrieved 21 December 2019.
  3. ^ a b c d e f g h i j k l m n o Ludlow JT, Wilkerson RG, Nappe TM (January 2019). "Methemoglobinemia". StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. PMID 30726002.
  4. ^ Wettstein ZS, Yarid NA, Shah S (December 2022). "Fatal methaemoglobinemia due to intentional sodium nitrite ingestion". BMJ Case Reports. 15 (12): e252954. doi:10.1136/bcr-2022-252954. PMC 9748921. PMID 36524260.

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