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Toxic methemoglobinemia with cyanosis

MedGen UID:
688234
•Concept ID:
C1263992
•
Disease or Syndrome
Synonym: Toxic Methemoglobinemia with Cyanosis
SNOMED CT: Toxic methemoglobinemia with cyanosis (127037003)

Definition

Blue skin coloration due to elevated blood levels of methemoglobin. The degree of cyanosis is directly correlated to the concentration of methemoglobin in the blood. As methemoglobin is not suitable for carrying oxygen, hypoxemia becomes a serious sequela. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVToxic methemoglobinemia with cyanosis

Professional guidelines

PubMed

Occupational methaemoglobinaemia. Mechanisms of production, features, diagnosis and management including the use of methylene blue.
Bradberry SM
Toxicol Rev 2003;22(1):13-27. doi: 10.2165/00139709-200322010-00003. PMID: 14579544

Recent clinical studies

Etiology

Acquired Methemoglobinemia - A Sporadic Holi Disaster.
Masavkar SS, Mauskar A, Patwardhan G, Bhat V, Manglani MV
Indian Pediatr 2017 Jun 15;54(6):473-475. doi: 10.1007/s13312-017-1050-1. PMID: 28667718
Disorders of oxidised haemoglobin.
Percy MJ, McFerran NV, Lappin TR
Blood Rev 2005 Mar;19(2):61-8. doi: 10.1016/j.blre.2004.02.001. PMID: 15603910
When patients become cyanotic: acquired methemoglobinemia.
Wilburn-Goo D, Lloyd LM
J Am Dent Assoc 1999 Jun;130(6):826-31. doi: 10.14219/jada.archive.1999.0306. PMID: 10377640
Benzocaine-induced methemoglobinemia: report of a severe reaction and review of the literature.
Rodriguez LF, Smolik LM, Zbehlik AJ
Ann Pharmacother 1994 May;28(5):643-9. doi: 10.1177/106002809402800515. PMID: 8069004
Methemoglobinemia: nitrate toxicity in rural America.
Kross BC, Ayebo AD, Fuortes LJ
Am Fam Physician 1992 Jul;46(1):183-8. PMID: 1621630

Diagnosis

METHEMOGLOBINEMIA - A CASE REPORT 
AND LITERATURE REVIEW.
Ivek I, Knotek T, Ivičić T, Rubinić B, Bajlo P, Hamzić J
Acta Clin Croat 2022 Jun;61(Suppl 1):93-98. doi: 10.20471/acc.2022.61.s1.16. PMID: 36304805Free PMC Article
Pediatric Toxidrome Simulation Curriculum: Lidocaine-Induced Methemoglobinemia.
Rosso CD, Thomas A, Hardy N, Connelly S, Davila U, Pearce J, Mazor S, Burns R
MedEdPORTAL 2021 Jan 28;17:11089. doi: 10.15766/mep_2374-8265.11089. PMID: 33537407Free PMC Article
Acquired Methemoglobinemia - A Sporadic Holi Disaster.
Masavkar SS, Mauskar A, Patwardhan G, Bhat V, Manglani MV
Indian Pediatr 2017 Jun 15;54(6):473-475. doi: 10.1007/s13312-017-1050-1. PMID: 28667718
Disorders of oxidised haemoglobin.
Percy MJ, McFerran NV, Lappin TR
Blood Rev 2005 Mar;19(2):61-8. doi: 10.1016/j.blre.2004.02.001. PMID: 15603910
Methemoglobinemia.
Curry S
Ann Emerg Med 1982 Apr;11(4):214-21. doi: 10.1016/s0196-0644(82)80502-7. PMID: 7073040

Therapy

METHEMOGLOBINEMIA - A CASE REPORT 
AND LITERATURE REVIEW.
Ivek I, Knotek T, Ivičić T, Rubinić B, Bajlo P, Hamzić J
Acta Clin Croat 2022 Jun;61(Suppl 1):93-98. doi: 10.20471/acc.2022.61.s1.16. PMID: 36304805Free PMC Article
Fatal Sodium Nitrite Poisoning: Key Considerations for Prehospital Providers.
Neth MR, Love JS, Horowitz BZ, Shertz MD, Sahni R, Daya MR
Prehosp Emerg Care 2021 Nov-Dec;25(6):844-850. Epub 2020 Nov 5 doi: 10.1080/10903127.2020.1838009. PMID: 33074043
When patients become cyanotic: acquired methemoglobinemia.
Wilburn-Goo D, Lloyd LM
J Am Dent Assoc 1999 Jun;130(6):826-31. doi: 10.14219/jada.archive.1999.0306. PMID: 10377640
Methemoglobinemia: nitrate toxicity in rural America.
Kross BC, Ayebo AD, Fuortes LJ
Am Fam Physician 1992 Jul;46(1):183-8. PMID: 1621630
Methemoglobinemia.
Curry S
Ann Emerg Med 1982 Apr;11(4):214-21. doi: 10.1016/s0196-0644(82)80502-7. PMID: 7073040

Prognosis

Methemoglobinemia due to use of poppers: a case report.
Sonck E, Bourmanne E, Bruteyn J, Dolip W
J Med Case Rep 2022 Jun 21;16(1):244. doi: 10.1186/s13256-022-03475-8. PMID: 35725643Free PMC Article
Benzocaine-induced methaemoglobinaemia: a case study.
Bittmann S, Krüger C
Br J Nurs 2011 Feb 10-23;20(3):168-70. doi: 10.12968/bjon.2011.20.3.168. PMID: 21378638
Metobromuron/metolachlor ingestion with late onset methemoglobinemia in a pregnant woman successfully treated with methylene blue.
Yang CC, Hwang SF, Chou MM, Deng JF
J Toxicol Clin Toxicol 1995;33(6):713-6. doi: 10.3109/15563659509010635. PMID: 8523499
Antitumor activity and clinical pharmacology of sulofenur in ovarian cancer.
Taylor CW, Alberts DS, Peng YM, McCloskey TM, Matzner M, Roe DJ, Plezia PM, Grindey GB, Hamilton M, Seitz D
J Natl Cancer Inst 1992 Dec 2;84(23):1798-802. doi: 10.1093/jnci/84.23.1798. PMID: 1433369

Clinical prediction guides

Methemoglobinemia and Delayed Encephalopathy After 5-Bromo-2-Nitropyridine Poisoning: A Rare Case Report.
Shi L, Yu G, Zhao L, Wen Z, Li Y, Kan B, Jian X
Front Public Health 2022;10:942003. Epub 2022 Jul 7 doi: 10.3389/fpubh.2022.942003. PMID: 35875039Free PMC Article
Whole bowel irrigation in dapsone intoxication with persistent methemoglobinemia.
Carboni Bisso I, Gemelli N, Cordero MP, Barrios C, Pina D
Am J Emerg Med 2020 Oct;38(10):2246.e1-2246.e2. Epub 2020 May 23 doi: 10.1016/j.ajem.2020.05.056. PMID: 32507475
Severe methemoglobinemia due to ingestion of toxicants.
D'sa SR, Victor P, Jagannati M, Sudarsan TI, Carey RA, Peter JV
Clin Toxicol (Phila) 2014 Sep-Oct;52(8):897-900. Epub 2014 Aug 12 doi: 10.3109/15563650.2014.947377. PMID: 25116418
Occupational methaemoglobinaemia. Mechanisms of production, features, diagnosis and management including the use of methylene blue.
Bradberry SM
Toxicol Rev 2003;22(1):13-27. doi: 10.2165/00139709-200322010-00003. PMID: 14579544
Antitumor activity and clinical pharmacology of sulofenur in ovarian cancer.
Taylor CW, Alberts DS, Peng YM, McCloskey TM, Matzner M, Roe DJ, Plezia PM, Grindey GB, Hamilton M, Seitz D
J Natl Cancer Inst 1992 Dec 2;84(23):1798-802. doi: 10.1093/jnci/84.23.1798. PMID: 1433369

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