Methemoglobinemia natural history, complications and prognosis
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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.
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.