Philippe Camus, M.D.

Dijon, France

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XXIII.a

Methemoglobinemia

Known since the 1940s (PMID 18883450). Comprehensive list of causal drugs and chemicals available at PMID 1564446. Methemoglobin is the oxidized (Fe3+) species of hemoglobin (Fe2+). Patients present with slate-grey cyanosis, low SpO2, normal SaO2 and PaO2. Normally, methemoglobin is <1%. Levels above 40% can be life-threatening, producing pulmonary edema, cardiovascular collapse (PMID 17122537) CNS disturbances and death. Management includes i.v. methylene blue. A possible rebound increase in MeHb upon treatment requires close monitoring. Excess methylene blue can also produce methemoglobinemia. Guidelines: PMID 34467556.

Publications

Nguta JM

Nitrate Poisoning due to Ingestion of Cabbages ( var. L.) (Brassicaceae) in Kitui County, Kenya.

TheScientificWorldJournal 2019;2019;8716518 — 2019 — 8716518

Savino F, Maccario S, Guidi C, Castagno E, Farinasso D, Cresi F, Silvestro L, Mussa GC

Methemoglobinemia caused by the ingestion of courgette soup given in order to resolve constipation in two formula-fed infants.

Annals of nutrition & metabolism 2006;50;368-71 — 2006 — 368-71

SINIOS A

[METHEMOGLOBINEMIA CAUSED BY NITRITE CONTAINING SPINACH. PRELIMINARY REPORT].

Munchener medizinische Wochenschrift (1950) 1964 Jun 26;106;1180-2 — 1964 Jun 26 — 1180-2