Methemoglobinemia: Etiology, Pharmacology, and Clinical Management

Methemoglobin (MHb) may arise from a variety of etiologies including genetic, dietary, idiopathic, and toxicologic sources. Symptoms vary from mild headache to coma/death and may not correlate with measured MHb concentrations. Toxin-induced MHb may be complicated by the drug’s effect on other organ...

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Bibliographic Details
Published in:Annals of emergency medicine 1999-11, Vol.34 (5), p.646-656
Main Authors: Wright, Robert O, Lewander, William J, Woolf, Alan D
Format: Article
Language:English
Subjects:
Anemias. Hemoglobinopathies
Biological and medical sciences
Diseases of red blood cells
Hematologic and hematopoietic diseases
Humans
Medical sciences
Methemoglobinemia - diagnosis
Methemoglobinemia - etiology
Methemoglobinemia - physiopathology
Methemoglobinemia - therapy
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Summary:Methemoglobin (MHb) may arise from a variety of etiologies including genetic, dietary, idiopathic, and toxicologic sources. Symptoms vary from mild headache to coma/death and may not correlate with measured MHb concentrations. Toxin-induced MHb may be complicated by the drug’s effect on other organ systems such as the liver or lungs. The existence of underlying heart, lung, or blood disease may exacerbate the toxicity of MHb. The diagnosis may be complicated by the effect of MHb on arterial blood gas and pulse oximeter oxygen saturation results. In addition, other dyshemoglobins may be confused with MHb. Treatment with methylene blue can be complicated by the presence of underlying enzyme deficiencies, including glucose-6-phosphate dehydrogenase deficiency. Experimental antidotes for MHb may provide alternative treatments in the future, but require further study. [Wright RO, Lewander WJ, Woolf AD: Methemoglobinemia: Etiology, pharmacology, and clinical management. Ann Emerg Med November 1999;34:646-656.]
ISSN:0196-0644
1097-6760
DOI:10.1016/S0196-0644(99)70167-8