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*High doses of [[antidote treatment]] for [[methemogobinemia]] - ([[Methylene blue]]) can also cause [[cyanotic discoloration of the skin]] as a side effect, but this should not lead you into thinking that the treatment is inefficient. <ref>{{Rev Bras Anestesiol. 2008 Nov-Dec;58(6):651-64. Methemoglobinemia: from diagnosis to treatment. [Article in English, Portuguese] do Nascimento TS1, Pereira RO, de Mello HL, Costa J. pmid=19082413}}</ref>
*High doses of [[antidote treatment]] for [[methemogobinemia]] - ([[Methylene blue]]) can also cause [[cyanotic discoloration of the skin]] as a side effect, but this should not lead you into thinking that the treatment is inefficient. <ref>{{Rev Bras Anestesiol. 2008 Nov-Dec;58(6):651-64. Methemoglobinemia: from diagnosis to treatment. [Article in English, Portuguese] do Nascimento TS1, Pereira RO, de Mello HL, Costa J. pmid=19082413}}</ref>


*Depending on the levels of [[MetHb]] in the [[blood]] we can observe different clinical presentation as follows:  
*Depending on the levels of [[MetHb]] in the [[blood]] we can observe different clinical presentation as follows<ref>{{Rev Bras Anestesiol. 2008 Nov-Dec;58(6):651-64. Methemoglobinemia: from diagnosis to treatment. [Article in English, Portuguese] do Nascimento TS1, Pereira RO, de Mello HL, Costa J. pmid=19082413}}</ref>    <ref>{{Toxicol Rev. 2003;22(1):13-27.
Occupational methaemoglobinaemia. Mechanisms of production, features, diagnosis and management including the use of methylene blue.
Bradberry SM1. pmid=14579544}}</ref>
:  
*MetHb levels of 15% lead to skin and blood color (chocolate-brown) changes .  
*MetHb levels of 15% lead to skin and blood color (chocolate-brown) changes .  
*MetHb levels above 15% lead to [[hypoxia]].
*MetHb levels above 15% lead to [[hypoxia]].

Revision as of 14:07, 15 May 2018

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

Overview

Differentiating Methemoglobinemia from other Diseases

  • Methemoglobinemia can present with similar signs and symptoms of other conditions causing hypoxia (as listed below). Note that the hypoxia in methemogobinemia will be unresponsive to oxygen treatment, in comparison to cardiac and pulmonary causes of hypoxia.

Heart failure

Pulmonary embolism

Polycythemia[1]

Anemia

Rasbirucase (Rx Tumor Lysis Syndrome) [2]

Metabolic Acidosis

Methylene Blue treatment

Sulfhemoglobin

Asthma

  • Depending on the levels of MetHb in the blood we can observe different clinical presentation as follows[4] [5]
  • MetHb levels of 15% lead to skin and blood color (chocolate-brown) changes .
  • MetHb levels above 15% lead to hypoxia.
  • MetHb levels above 70% lead to death.

References

  1. {{Hematol Rep. 2018 Mar 2;10(1):7221. doi: 10.4081/hr.2018.7221. eCollection 2018 Mar 2. Congenital methemoglobinemia misdiagnosed as polycythemia vera: Case report and review of literature. Soliman DS1,2, Yassin M3. PMID: 29721250 }}
  2. {{Curr Drug Saf. 2017;12(1):13-18. doi: 10.2174/1574886312666170111151246. Rasburicase-Induced Methemoglobinemia in a Patient with Glucose-6- Phosphate Dehydrogenase Deficiency. Khan M, Paul S, Farooq S, Oo TH, Ramshesh P, Jain N1. PMID: 28078984 }}
  3. {{Rev Bras Anestesiol. 2008 Nov-Dec;58(6):651-64. Methemoglobinemia: from diagnosis to treatment. [Article in English, Portuguese] do Nascimento TS1, Pereira RO, de Mello HL, Costa J. pmid=19082413}}
  4. {{Rev Bras Anestesiol. 2008 Nov-Dec;58(6):651-64. Methemoglobinemia: from diagnosis to treatment. [Article in English, Portuguese] do Nascimento TS1, Pereira RO, de Mello HL, Costa J. pmid=19082413}}
  5. {{Toxicol Rev. 2003;22(1):13-27. Occupational methaemoglobinaemia. Mechanisms of production, features, diagnosis and management including the use of methylene blue. Bradberry SM1. pmid=14579544}}

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