Methemoglobinemia history and symptoms: Difference between revisions

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{{Methemoglobinemia }}
{{Methemoglobinemia }}


{{CMG}}
{{CMG}}; {{AE}}{{AKS}}


==Overview==
==Overview==
 
Methemoglobinemia will present with different signs and symptoms depending on the methemoglobin levels in the blood.
'''Congenital (Hereditary) Methemoglobinemia'''
 
There are three main congenital conditions that lead to methemoglobinemia:
 
1. Cytochrome b5 reductase deficiency and pyruvate kinase deficiency
 
2. G6PD deficiency
 
3. Presence of abnormal hemoglobin.
 
 
'''Acquired or Acute Methemoglobinemia'''
 
Most common cause include different oxidant drugs, toxins or chemicals


==History and Symptoms==
==History and Symptoms==


Signs and symptoms of methemoglobinemia (methemoglobin >1%) include shortness of breath, cyanosis, mental status changes, headache, fatigue, exercise intolerance, dizziness and loss of consciousness. Arterial blood with elevated methemoglobin levels has a characteristic chocolate-brown color as compared to normal bright red oxygen containing arterial blood.
*Depending on the levels of [[MetHb]] in the blood we can observe different symptoms as follows: Patients with [[MetHb]] levels of up to 15% will present with skin and blood color (chocolate-brown) changes. Patients with [[MetHb]] levels above 15% will present with [[hypoxia]] and [[MetHb]] levels above 70% can lead to death.<ref name="pmid19082413">{{cite journal| author=do Nascimento TS, Pereira RO, de Mello HL, Costa J| title=Methemoglobinemia: from diagnosis to treatment. | journal=Rev Bras Anestesiol | year= 2008 | volume= 58 | issue= 6 | pages= 651-64 | pmid=19082413 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19082413  }} </ref>  <ref name="pmid14579544">{{cite journal| author=Bradberry SM| title=Occupational methaemoglobinaemia. Mechanisms of production, features, diagnosis and management including the use of methylene blue. | journal=Toxicol Rev | year= 2003 | volume= 22 | issue= 1 | pages= 13-27 | pmid=14579544 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14579544  }} </ref>
*[[Cyanosis]] that is unresponsive to [[oxygen]] treatment is the main physical finding in people with [[methemoglobinemia]], along with that the patient can present with [[dizziness]], [[nausea]] and [[shortness of breath]].


Severe methemoglobinemia (methemoglobin >50%) patients have dysrhythmias, seizures, coma and death. Healthy people may not have many symptoms with methemoglobin levels < 15%, however patients with co-morbidities such as anemia, cardiovascular disease, lung disease, sepsis, or presence of other abnormal hemoglobin species (e.g. carboxyhemoglobin, sulfehemoglobin or sickle hemoglobin) may experience moderate to severe symptoms at much lower levels (as low as 5-8%).
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 21:30, 31 July 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aksiniya Stevasarova, M.D.

Overview

Methemoglobinemia will present with different signs and symptoms depending on the methemoglobin levels in the blood.

History and Symptoms

  • Depending on the levels of MetHb in the blood we can observe different symptoms as follows: Patients with MetHb levels of up to 15% will present with skin and blood color (chocolate-brown) changes. Patients with MetHb levels above 15% will present with hypoxia and MetHb levels above 70% can lead to death.[1] [2]
  • Cyanosis that is unresponsive to oxygen treatment is the main physical finding in people with methemoglobinemia, along with that the patient can present with dizziness, nausea and shortness of breath.

References

  1. do Nascimento TS, Pereira RO, de Mello HL, Costa J (2008). "Methemoglobinemia: from diagnosis to treatment". Rev Bras Anestesiol. 58 (6): 651–64. PMID 19082413.
  2. Bradberry SM (2003). "Occupational methaemoglobinaemia. Mechanisms of production, features, diagnosis and management including the use of methylene blue". Toxicol Rev. 22 (1): 13–27. PMID 14579544.

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