Methemoglobinemia differential diagnosis: Difference between revisions

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• [[Pulmonary embolism]]
• [[Pulmonary embolism]]


• [[Polycythemia]]<ref>{{Hematol Rep. 2018 Mar 2;10(1):7221. doi: 10.4081/hr.2018.7221. eCollection 2018 Mar 2.
• [[Polycythemia]]<ref name="pmid29721250">{{cite journal| author=Soliman DS, Yassin M| title=Congenital methemoglobinemia misdiagnosed as polycythemia vera: Case report and review of literature. | journal=Hematol Rep | year= 2018 | volume= 10 | issue= 1 | pages= 7221 | pmid=29721250 | doi=10.4081/hr.2018.7221 | pmc=5907642 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29721250 }} </ref>
Congenital methemoglobinemia misdiagnosed as polycythemia vera: Case report and review of literature.
Soliman DS1,2, Yassin M3. PMID: 29721250 }}</ref>
 
• [[Anemia]]
• [[Anemia]]


• [[Rasbirucase]] (Rx [[Tumor Lysis Syndrome]]) <ref>{{Curr Drug Saf. 2017;12(1):13-18. doi: 10.2174/1574886312666170111151246.
• [[Rasbirucase]] (Rx [[Tumor Lysis Syndrome]]) <ref name="pmid28078984">{{cite journal| author=Khan M, Paul S, Farooq S, Oo TH, Ramshesh P, Jain N| title=Rasburicase-Induced Methemoglobinemia in a Patient with Glucose-6- Phosphate Dehydrogenase Deficiency. | journal=Curr Drug Saf | year= 2017 | volume= 12 | issue= 1 | pages= 13-18 | pmid=28078984 | doi=10.2174/1574886312666170111151246 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28078984 }} </ref>
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 }}</ref>


• [[Metabolic Acidosis]]
• [[Metabolic Acidosis]]
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• [[Asthma]]
• [[Asthma]]


*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 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>


*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.
*Depending on the levels of [[MetHb]] in the [[blood]] we can observe different clinical presentation as follows<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>
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 .  

Revision as of 12:51, 15 June 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[3] [4]
  • 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. Soliman DS, Yassin M (2018). "Congenital methemoglobinemia misdiagnosed as polycythemia vera: Case report and review of literature". Hematol Rep. 10 (1): 7221. doi:10.4081/hr.2018.7221. PMC 5907642. PMID 29721250.
  2. Khan M, Paul S, Farooq S, Oo TH, Ramshesh P, Jain N (2017). "Rasburicase-Induced Methemoglobinemia in a Patient with Glucose-6- Phosphate Dehydrogenase Deficiency". Curr Drug Saf. 12 (1): 13–18. doi:10.2174/1574886312666170111151246. PMID 28078984.
  3. 3.0 3.1 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.
  4. 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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