Description
High levels of a form of hemoglobin called methemoglobin are found in the blood. This may be caused either by an inherited condition or by exposure to a medication or drug. Hemoglobin carries the oxygen in the blood and is found within the red blood cells. Because methemoglobin is not able to carry oxygen normally, it causes a bluish discoloration to the skin. The most common drugs to cause the disorder are: benzocaine, lidocaine, dapsone, chloroquine, nitrates, and nitrites. Nitrates are sometimes inhaled and used as a drug of abuse called "poppers". The disease can be very serious leading to very low blood pressure, seizures and death.
Symptoms
Bluish color to the skin (cyanosis), breathing problems, fatigue. The inherited type can cause stunted growth, mental retardation, seizures, and failure to thrive.
Tests
Common tests used for diagnosis and treatment
Workup:
A history and physical exam will be done. Blood tests are done to confirm the disorder.
Specialists:
Blood and Cancer Care (hematology and oncology), Pediatric Hematology and Oncology, Medical Toxicology
Workup:
A history and physical exam will be done. Blood tests are done to confirm the disorder.
Specialists:
Blood and Cancer Care (hematology and oncology), Pediatric Hematology and Oncology, Medical Toxicology
Treatment
Patients will be given oxygen. Methylene blue is given intravenously to reverse the methemoglobin. Other treatment options include hyperbaric oxygen and exchange transfusions.