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
Causative drugs
85
Sulfamides - Sulfonamides
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.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) II.u II - Pulmonary edema - Acute lung injury - ARDS
II.u - Acute respiratory failure (e.g. from ARDS, ILD, PIE, OP, pulmonary edema or bronchospasm) requiring ECMO V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) VI.d VI - Pulmonary vasculopathies
VI.d - Pulmonary vasculitis or capillaritis 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) XII.d XII - Cardiovascular involvement / toxicity
XII.d - Myocarditis (can be fulminant) XIV.a XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)
XIV.a - Methemoglobinemia XIV.b XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)
XIV.b - Sulfhemoglobinemia XV.g XV - Pathology
XV.g - Path: Alveolar hemorrhage (see also IIIa) XV.ac XV - Pathology
XV.ac - Path: Pulmonary vasculitis other than capillaritis XXIV.a XXIV - Veterinary medicine
XXIV.a - Veterinary: Pneumonitis - Interstitial lung disease
I.b - Pneumonitis (ILD) 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) II.u II - Pulmonary edema - Acute lung injury - ARDS
II.u - Acute respiratory failure (e.g. from ARDS, ILD, PIE, OP, pulmonary edema or bronchospasm) requiring ECMO V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) VI.d VI - Pulmonary vasculopathies
VI.d - Pulmonary vasculitis or capillaritis 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) XII.d XII - Cardiovascular involvement / toxicity
XII.d - Myocarditis (can be fulminant) XIV.a XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)
XIV.a - Methemoglobinemia XIV.b XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)
XIV.b - Sulfhemoglobinemia XV.g XV - Pathology
XV.g - Path: Alveolar hemorrhage (see also IIIa) XV.ac XV - Pathology
XV.ac - Path: Pulmonary vasculitis other than capillaritis XXIV.a XXIV - Veterinary medicine
XXIV.a - Veterinary: Pneumonitis - Interstitial lung disease
1
Sulfasalazine
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.g I - Interstitial/parenchymal lung disease
I.g - Pulmonary fibrosis I.m I - Interstitial/parenchymal lung disease
I.m - ILD with a granulomatous component II.d II - Pulmonary edema - Acute lung injury - ARDS
II.d - Pulmonary edema, cardiogenic IV.y IV - Airway involvement
IV.y - Eosinophilic airway disease (asthma, bronchitis, bronchiolitis) V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) V.b V - Pleural and/or pericardial involvement
V.b - Eosinophilic pleural effusion V.d V - Pleural and/or pericardial involvement
V.d - Pleural/pericardial effusion, ANA positive (DI lupus) V.m V - Pleural and/or pericardial involvement
V.m - Pleuropericarditis - Pleuropericardial effusion (ANA unknown or negative) VI.d VI - Pulmonary vasculopathies
VI.d - Pulmonary vasculitis or capillaritis VII.a VII - Mediastinal involvement
VII.a - Lymphadenopathy (intrathoracic) 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.g X - Systemic/Distant conditions, syndromes and reactions
X.g - Hypersensitivity reaction (may manifest with fever and/or skin, throat or airway involvement) X.k X - Systemic/Distant conditions, syndromes and reactions
X.k - Sarcoid-like granulomatosis (endo-/extrathoracic) X.s X - Systemic/Distant conditions, syndromes and reactions
X.s - Vasculitis, pulmonary (w/wo AH), extrapulmonary, systemic: ANCA-positive X.u X - Systemic/Distant conditions, syndromes and reactions
X.u - Multiple organ dysfunction/failure (MODS/MOF) XI.b XI - Miscellaneous
XI.b - Chest pain (acute or subacute), lone or prominent XI.c XI - Miscellaneous
XI.c - Pleuritic chest pain XII.c XII - Cardiovascular involvement / toxicity
XII.c - Pericardial effusion (w/wo tamponade) XII.d XII - Cardiovascular involvement / toxicity
XII.d - Myocarditis (can be fulminant) XII.h XII - Cardiovascular involvement / toxicity
XII.h - Eosinophilic myocarditis 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) XV.e XV - Pathology
XV.e - Path: ILD with a granulomatous component (see also Im) XV.f XV - Pathology
XV.f - Path: Diffuse alveolar damage (DAD-pattern) (see also IL) XV.k XV - Pathology
XV.k - Path: Desquamative interstitial pneumonia (DIP-pattern) XV.ac XV - Pathology
XV.ac - Path: Pulmonary vasculitis other than capillaritis XVII.w XVII - Infections & related conditions
XVII.w - Hypogammaglobulinemia - Antibody deficiency XIX.a XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.a - BAL: An excess proportion of lymphocytes XIX.c XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.c - BAL: An excess proportion of eosinophils
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.g I - Interstitial/parenchymal lung disease
I.g - Pulmonary fibrosis I.m I - Interstitial/parenchymal lung disease
I.m - ILD with a granulomatous component II.d II - Pulmonary edema - Acute lung injury - ARDS
II.d - Pulmonary edema, cardiogenic IV.y IV - Airway involvement
IV.y - Eosinophilic airway disease (asthma, bronchitis, bronchiolitis) V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) V.b V - Pleural and/or pericardial involvement
V.b - Eosinophilic pleural effusion V.d V - Pleural and/or pericardial involvement
V.d - Pleural/pericardial effusion, ANA positive (DI lupus) V.m V - Pleural and/or pericardial involvement
V.m - Pleuropericarditis - Pleuropericardial effusion (ANA unknown or negative) VI.d VI - Pulmonary vasculopathies
VI.d - Pulmonary vasculitis or capillaritis VII.a VII - Mediastinal involvement
VII.a - Lymphadenopathy (intrathoracic) 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.g X - Systemic/Distant conditions, syndromes and reactions
X.g - Hypersensitivity reaction (may manifest with fever and/or skin, throat or airway involvement) X.k X - Systemic/Distant conditions, syndromes and reactions
X.k - Sarcoid-like granulomatosis (endo-/extrathoracic) X.s X - Systemic/Distant conditions, syndromes and reactions
X.s - Vasculitis, pulmonary (w/wo AH), extrapulmonary, systemic: ANCA-positive X.u X - Systemic/Distant conditions, syndromes and reactions
X.u - Multiple organ dysfunction/failure (MODS/MOF) XI.b XI - Miscellaneous
XI.b - Chest pain (acute or subacute), lone or prominent XI.c XI - Miscellaneous
XI.c - Pleuritic chest pain XII.c XII - Cardiovascular involvement / toxicity
XII.c - Pericardial effusion (w/wo tamponade) XII.d XII - Cardiovascular involvement / toxicity
XII.d - Myocarditis (can be fulminant) XII.h XII - Cardiovascular involvement / toxicity
XII.h - Eosinophilic myocarditis 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) XV.e XV - Pathology
XV.e - Path: ILD with a granulomatous component (see also Im) XV.f XV - Pathology
XV.f - Path: Diffuse alveolar damage (DAD-pattern) (see also IL) XV.k XV - Pathology
XV.k - Path: Desquamative interstitial pneumonia (DIP-pattern) XV.ac XV - Pathology
XV.ac - Path: Pulmonary vasculitis other than capillaritis XVII.w XVII - Infections & related conditions
XVII.w - Hypogammaglobulinemia - Antibody deficiency XIX.a XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.a - BAL: An excess proportion of lymphocytes XIX.c XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.c - BAL: An excess proportion of eosinophils
1
Trimethoprim sulfamethoxazole (TMP-SMX)
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.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP) I.f I - Interstitial/parenchymal lung disease
I.f - Acute fibrinous organizing pneumonia (AFOP) 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.u II - Pulmonary edema - Acute lung injury - ARDS
II.u - Acute respiratory failure (e.g. from ARDS, ILD, PIE, OP, pulmonary edema or bronchospasm) requiring ECMO V.f V - Pleural and/or pericardial involvement
V.f - Pneumothorax X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.e X - Systemic/Distant conditions, syndromes and reactions
X.e - Autoimmunity-Autoimmune conditions (+ANA, +anti-ds-DNA, +ANCAs, other auto-Abs) 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.x X - Systemic/Distant conditions, syndromes and reactions
X.x - Subclinical ANCA positivity XIV.a XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)
XIV.a - Methemoglobinemia XV.b XV - Pathology
XV.b - Path: Eosinophilic pneumonia (subacute or acute) (see also Ic) XV.f XV - Pathology
XV.f - Path: Diffuse alveolar damage (DAD-pattern) (see also IL) XV.ct XV - Pathology
XV.ct - Path: Delayed alveolar injury with delayed epithelialization (DAIDE) XVI.bb XVI - Imaging
XVI.bb - Imaging: Pneumomediastinum XIX.c XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.c - BAL: An excess proportion of eosinophils
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.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP) I.f I - Interstitial/parenchymal lung disease
I.f - Acute fibrinous organizing pneumonia (AFOP) 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.u II - Pulmonary edema - Acute lung injury - ARDS
II.u - Acute respiratory failure (e.g. from ARDS, ILD, PIE, OP, pulmonary edema or bronchospasm) requiring ECMO V.f V - Pleural and/or pericardial involvement
V.f - Pneumothorax X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.e X - Systemic/Distant conditions, syndromes and reactions
X.e - Autoimmunity-Autoimmune conditions (+ANA, +anti-ds-DNA, +ANCAs, other auto-Abs) 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.x X - Systemic/Distant conditions, syndromes and reactions
X.x - Subclinical ANCA positivity XIV.a XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)
XIV.a - Methemoglobinemia XV.b XV - Pathology
XV.b - Path: Eosinophilic pneumonia (subacute or acute) (see also Ic) XV.f XV - Pathology
XV.f - Path: Diffuse alveolar damage (DAD-pattern) (see also IL) XV.ct XV - Pathology
XV.ct - Path: Delayed alveolar injury with delayed epithelialization (DAIDE) XVI.bb XVI - Imaging
XVI.bb - Imaging: Pneumomediastinum XIX.c XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.c - BAL: An excess proportion of eosinophils
1
Waterproofing agents/sprays - Household cleansing agents and aerosols
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.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP) I.y I - Interstitial/parenchymal lung disease
I.y - Progression, acceleration or exacerbation of preexisting ILD/fibrosis 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) XI.r XI - Miscellaneous
XI.r - Death following exposure or poisoning XIV.a XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)
XIV.a - Methemoglobinemia
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP) I.y I - Interstitial/parenchymal lung disease
I.y - Progression, acceleration or exacerbation of preexisting ILD/fibrosis 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) XI.r XI - Miscellaneous
XI.r - Death following exposure or poisoning XIV.a XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)
XIV.a - Methemoglobinemia
1