Methemoglobinemia natural history, complications and prognosis: Difference between revisions
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{{Methemoglobinemia}} | {{Methemoglobinemia}} | ||
{{CMG}}; {{AE}}{{ | {{CMG}}; {{AE}}{{AKS}} | ||
==Overview== | ==Overview== | ||
Depending on the causes that have led to methemoglobin formation, different complications and prognosis are expected respectively. Death is the most serious complications of methemoglobinemia especially when [[MetHb]] levels approach 70%. In severely sick patients death may occur even with lower levels of [[MetHb]]. | |||
==Natural History== | ==Natural History== | ||
Patients with hereditary forms of [[methemoglobinemia]] are generally asymptomatic, with the exception of having chronic [[cyanosis]]. Unfortunately, despite the benign nature of the [[congenital]] methemoglobinemia, people with type [[IIb5 cytochrome-reductase deficiency]] have poor prognosis and shorter lifespan, mainly due to neurologic complications. | *Patients with hereditary forms of [[methemoglobinemia]] are generally asymptomatic, with the exception of having chronic [[cyanosis]]. Unfortunately, despite the benign nature of the [[congenital]] methemoglobinemia, people with type [[IIb5 cytochrome-reductase deficiency]] have poor prognosis and shorter lifespan, mainly due to neurologic complications. | ||
In acquired [[methemoglobinemia]], depending on the amount and duration of toxin exposure, the levels of MetHb in the blood will be different. As a result we expect different outcomes, which are as follows: MetHb of 15% presents with skin and blood color changes at levels; levels above 15% will result in [[hypoxia]] and levels above 70% can lead to death. <ref>{{ | *In acquired [[methemoglobinemia]], depending on the amount and duration of toxin exposure, the levels of [[MetHb]] in the blood will be different. As a result we expect different outcomes, which are as follows: MetHb of 15% presents with skin and blood color changes at levels; levels above 15% will result in [[hypoxia]] and levels above 70% can lead to death. <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. | |||
==Complications== | ==Complications== | ||
Death is the most serious complications of methemoglobinemia especially when MetHb levels approach 70%. In severely sick patients death may occur even with lower levels of MetHb. Other complications include myocardial infarction, seizure and coma. | *Death is the most serious complications of methemoglobinemia especially when [[MetHb]] levels approach 70%. In severely sick patients death may occur even with lower levels of [[MetHb]]. | ||
Occupational methaemoglobinaemia. Mechanisms of production, features, diagnosis and management including the use of methylene blue. | *Other complications include [[myocardial infarction]], [[seizure]] and [[coma]]. <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> | ||
==Prognosis== | ==Prognosis== | ||
*Depending on the anoxic end-organ damage caused by MetHb, the prognosiss varies between mild | *Depending on the [[anoxic end-organ damage]] caused by [[MetHb]], the prognosiss varies between mild and fatal. <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> | ||
==References== | ==References== | ||
Latest revision as of 21:19, 31 July 2018
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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
Depending on the causes that have led to methemoglobin formation, different complications and prognosis are expected respectively. Death is the most serious complications of methemoglobinemia especially when MetHb levels approach 70%. In severely sick patients death may occur even with lower levels of MetHb.
Natural History
- Patients with hereditary forms of methemoglobinemia are generally asymptomatic, with the exception of having chronic cyanosis. Unfortunately, despite the benign nature of the congenital methemoglobinemia, people with type IIb5 cytochrome-reductase deficiency have poor prognosis and shorter lifespan, mainly due to neurologic complications.
- In acquired methemoglobinemia, depending on the amount and duration of toxin exposure, the levels of MetHb in the blood will be different. As a result we expect different outcomes, which are as follows: MetHb of 15% presents with skin and blood color changes at levels; levels above 15% will result in hypoxia and levels above 70% can lead to death. [1] [2]
Complications
- Death is the most serious complications of methemoglobinemia especially when MetHb levels approach 70%. In severely sick patients death may occur even with lower levels of MetHb.
- Other complications include myocardial infarction, seizure and coma. [2]
Prognosis
- Depending on the anoxic end-organ damage caused by MetHb, the prognosiss varies between mild and fatal. [1]
References
- ↑ 1.0 1.1 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.
- ↑ 2.0 2.1 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.