XIV.a

Methemoglobinemia

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

Last update : 01/01/1970
 

Causative drugs

85

Nitroprusside

1

Nonsteroidal anti-inflammatory drugs (NSAIDs)

I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP) II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma IV.f IV - Airway involvement
IV.f - Severe or catastrophic bronchospasm or asthma attack (can be fatal) V.q V - Pleural and/or pericardial involvement
V.q - Empyema VII.a VII - Mediastinal involvement
VII.a - Lymphadenopathy (intrathoracic) VIII.a VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.a - Angioedema (may cause UAO, asphyxia and death) VIII.y VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.y - Sinonasal discharge, -blockage, -obstruction IX.f IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.f - Hiccup X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.b X - Systemic/Distant conditions, syndromes and reactions
X.b - Antiphospholipid antibodies w/wo the APL syndrome X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.g X - Systemic/Distant conditions, syndromes and reactions
X.g - Hypersensitivity reaction (may manifest with fever and/or skin, throat or airway involvement) XI.b XI - Miscellaneous
XI.b - Chest pain (acute or subacute), lone or prominent XIV.a XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)
XIV.a - Methemoglobinemia
1

Para-dichlorobenzene

1

Paracetamol - Acetaminophen

1

Paraphenylenediamine (hair dye)

1

Pegloticase

1

Phenacetin

1

Phenazopyridine

2

Phenytoin (diphenylhydantoin)

I.a I - Interstitial/parenchymal lung disease
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) I.k I - Interstitial/parenchymal lung disease
I.k - Lung nodule or nodules II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) III.b III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.b - Pneumorenal syndrome (w/wo ANCAs) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma IV.d IV - Airway involvement
IV.d - Cough (lone) IV.n IV - Airway involvement
IV.n - Obstructive airway dysfunction (see also IVc, XVx) VI.d VI - Pulmonary vasculopathies
VI.d - Pulmonary vasculitis or capillaritis VII.a VII - Mediastinal involvement
VII.a - Lymphadenopathy (intrathoracic) VII.b VII - Mediastinal involvement
VII.b - Lymphadenopathy with reactive changes VII.m VII - Mediastinal involvement
VII.m - Malignant lymphoma X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.d X - Systemic/Distant conditions, syndromes and reactions
X.d - Lupus - Lupus syndrome (see also Vd) X.h X - Systemic/Distant conditions, syndromes and reactions
X.h - Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) X.m X - Systemic/Distant conditions, syndromes and reactions
X.m - Vascultis (pulmonary, extrathoracic or systemic)-ANCA status unknown or negative) X.u X - Systemic/Distant conditions, syndromes and reactions
X.u - Multiple organ dysfunction/failure (MODS/MOF) XI.ab XI - Miscellaneous
XI.ab - Gingival hypertrophy XII.m XII - Cardiovascular involvement / toxicity
XII.m - Cardiac- cardiorespiratory/pulmonary arrest XII.x XII - Cardiovascular involvement / toxicity
XII.x - Sinus arrest XII.as XII - Cardiovascular involvement / toxicity
XII.as - Giant cell myocarditis XIII.b XIII - Neoplastic conditions
XIII.b - Lymphoproliferative disease (pulmonary, endobronchial, endothoracic) XIV.a XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)
XIV.a - Methemoglobinemia XV.m XV - Pathology
XV.m - Path: Lymphoid hyperplasia (including nodular- or a lymphocytic interstitial pneumonia pattern) XV.ab XV - Pathology
XV.ab - Path: Pulmonary capillaritis XV.ac XV - Pathology
XV.ac - Path: Pulmonary vasculitis other than capillaritis XV.af XV - Pathology
XV.af - Path: Granulomatous pulmonary vasculitis XIX.a XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.a - BAL: An excess proportion of lymphocytes
1

Phosphine (H3P)

1

Piperazine

1

Potassium permanganate

1

Prilocaine

1

Primaquine

1

Propanil

2

Propitocaine

1

Pyrimethamine-dapsone

2

Quinine

I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury II.j II - Pulmonary edema - Acute lung injury - ARDS
II.j - Transient pulmonary opacities/infiltrates (see also under Iav) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) III.m III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.m - Coagulopathy VIII.b VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.b - Hematoma of/around central airway wall potentially causing UAO VIII.d VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement
VIII.d - Thermal (burns, frostbite), chemical or caustic injury on the face, mouth, tongue, pharynx or upper airway X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.g X - Systemic/Distant conditions, syndromes and reactions
X.g - Hypersensitivity reaction (may manifest with fever and/or skin, throat or airway involvement) X.h X - Systemic/Distant conditions, syndromes and reactions
X.h - Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) X.m X - Systemic/Distant conditions, syndromes and reactions
X.m - Vascultis (pulmonary, extrathoracic or systemic)-ANCA status unknown or negative) X.ad X - Systemic/Distant conditions, syndromes and reactions
X.ad - Skin purpura, ecchymoses or necrosis X.af X - Systemic/Distant conditions, syndromes and reactions
X.af - Thrombotic microangiopathy XI.b XI - Miscellaneous
XI.b - Chest pain (acute or subacute), lone or prominent XIV.a XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)
XIV.a - Methemoglobinemia XV.c XV - Pathology
XV.c - Path: Organizing pneumonia (OP/BOOP) pattern (see also Id)
1

Rasburicase

1

Resorcinol (1, 3 benzenediol) (topical/systemic)

1

Riluzole

1

Silver nitrate

1

Sodium nitrite (NaNO2)

1

Sulfacetamide

1

Sulfadiazine

1

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