Philippe Camus, M.D.

Dijon, France

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XIV.a

XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)

Methemoglobinemia

Last update 16/10/2014

See also under XIVa. 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

Causative drugs

90

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

I.a
I.b
I.e
I.k
I.ag
II.a
II.e
III.a
III.b
IV.h
IV.x
IV.ag
V.c
V.f
VI.a
X.o
X.w
X.ae
XI.p
XII.u
XIV.a
XIV.c
XVI.ac
XIX.al
XX.p
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