Methemoglobinemia causes

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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 may be caused by either congenital or acquired conditions.

Causes

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 (Hb M)


Acquired or Acute Methemoglobinemia

1. Drug Induced

Anesthetics[3] like benzocaine[4], lidocaine[5], prilocaine[6]

Methylene blue

Nitric oxide

Amyl Nitrate

Nitroglycerin

Antimalarial drugs like Primaquine phosphate (in nicotinamide adenine dinucleotide (NADH) methemoglobin reductase deficient individuals)

Rasburicase [7]

Sulfasalazine

Dapsone

Trimethoprim

Sulfonamides

Aniline dyes[8]

Metoclopramide

Chlorates and Bromates

2. Contaminated well water (in premature infants and infants younger than 4 months) [9] [10]

3. Solid foods (not well cooked vegetables high in nitrates in premature infants and infants younger than 4 months) [11] [12]

References

  1. Hall AH, Kulig KW, Rumack BH (1986). "Drug- and chemical-induced methaemoglobinaemia. Clinical features and management". Med Toxicol. 1 (4): 253–60. PMID 3537620.
  2. 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.
  3. Faust AC, Guy E, Baby N, Ortegon A (2018). "Local Anesthetic-Induced Methemoglobinemia During Pregnancy: A Case Report and Evaluation of Treatment Options". J Emerg Med. 54 (5): 681–684. doi:10.1016/j.jemermed.2018.01.039. PMID 29519718.
  4. Rodriguez LF, Smolik LM, Zbehlik AJ (1994). "Benzocaine-induced methemoglobinemia: report of a severe reaction and review of the literature". Ann Pharmacother. 28 (5): 643–9. doi:10.1177/106002809402800515. PMID 8069004.
  5. Gay HC, Amaral AP (2018). "Acquired Methemoglobinemia Associated with Topical Lidocaine Administration: A Case Report". Drug Saf Case Rep. 5 (1): 15. doi:10.1007/s40800-018-0081-4. PMC 5889764. PMID 29627919.
  6. Shamriz O, Cohen-Glickman I, Reif S, Shteyer E (2014). "Methemoglobinemia induced by lidocaine-prilocaine cream". Isr Med Assoc J. 16 (4): 250–4. PMID 24834764.
  7. 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.
  8. Messmer AS, Nickel CH, Bareiss D (2015). "P-chloroaniline poisoning causing methemoglobinemia: a case report and review of the literature". Case Rep Emerg Med. 2015: 208732. doi:10.1155/2015/208732. PMC 4377359. PMID 25861488.
  9. Brunato F, Garziera MG, Briguglio E (2003). "A severe methaemoglobinemia induced by nitrates: a case report". Eur J Emerg Med. 10 (4): 326–30. doi:10.1097/01.mej.0000103472.32882.db. PMID 14676514.
  10. [www.epa.gov/dwstandardsregulations]
  11. [www.fda.gov/Drugs/DrugSafety/ucm250024.htm]
  12. [www.fda.gov/forconsumers/consumerupdates/ucm306062.htm]


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