Methemoglobinemia - Symptoms, causes and treatment

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Methemoglobinemia - Symptoms, causes and treatment
Methemoglobinemia - Symptoms, causes and treatment

Methemoglobinemia is a blood disorder caused by excess methemoglobin. This disease is characterized by a bluish-looking skin color, especially around the lips and fingers

Methemoglobin is a form of hemoglobin that can carry oxygen, but cannot deliver it to body cells. Methemoglobin levels in the blood are considered normal if they range from 0-3%.

Methemoglobinemia - Alodokter

Causes of Methemoglobinemia

The causes of methemoglobinemia vary, depending on the type. Here's the explanation:

Inherited (congenital) methemoglobinemia

Congenital methemoglobinemia is inherited from both parents who have the gene that carries this disease.

Congenital methemoglobinemia is divided into:

  • Type 1, occurs when red blood cells lack the enzyme cytochrome b5 reductase.
  • Type 2, occurs when the cytochrome b5 reductase enzyme does not function normally.

Besides these two types, there is also a so-called hemoglobin M disease. This type of methemoglobinemia occurs due to a genetic abnormality in the hemoglobin protein. A person can get hemoglobin M disease if one of his parents suffers from this disease.

Acquired methemoglobinemia

Acquired methemoglobinemia is caused by drug side effects or exposure to certain chemicals. Some of these drugs and chemical compounds are:

  • Benzocaine
  • Lidocaine
  • Metoclopramide
  • Nitroglycerin
  • Phenytoin
  • Sulfonamides
  • Antimalaria
  • Herbicide
  • Insecticide
  • Nitrates
  • Nitrobenzene
  • Sodium chlorite
  • Ammonium carbonate

Methemoglobinemia Symptoms

Methemoglobinemia symptoms vary widely, depending on the type and cause. However, methemoglobinemia is generally characterized by cyanosis or bluish discoloration of the skin, especially in the areas of the lips and fingers.

In addition, other symptoms that may arise due to the body's lack of oxygen are:

  • Dizzy
  • Exhaustion
  • Nausea
  • Shortness of breath
  • Headache
  • Seizure

When to see a doctor

See your doctor if you experience the above symptoms or if you have a parent who suffers from methemoglobinemia. This is because methemoglobinemia can be passed from parents to children.

If you have a family history of methemoglobinemia and are planning to get married, do genetic counseling to find out how likely it is that methemoglobinemia will be passed down in your child.

Methemoglobinemia Diagnosis

To diagnose methemoglobinemia, the doctor will ask questions about the complaints you are experiencing. In newborns, complaints are usually in the form of bluish skin. Next, the doctor will do a physical examination.

To confirm the diagnosis, the doctor will perform several supporting examinations, such as:

  • Pulse oximetry examination, to see the saturation or oxygen levels in the body in general
  • Laboratory examination, which includes complete blood count, blood color examination, liver and kidney function, and blood gas analysis

Methemoglobinemia Treatment

Treatment of patients with methemoglobinemia varies, depending on the type. In patients with hemoglobin M disease, treatment is usually not needed because there are no symptoms.

To treat moderately severe methemoglobinemia, treatments that can be done include:

  • The administration of aspirin and ascorbic acid
  • Giving methylene blue or methylene blue
  • Hyperbaric oxygen therapy
  • Exchange transfusion
  • Blood Transfusion

It is important to note that methylene blue should not be given to methemoglobinemia patients who suffer from or are at risk of developing G6PD disease.

In acquired methemoglobinemia, patients need to avoid drugs and chemical compounds that cause it.

Methemoglobinemia Complications

In severe cases, methemoglobinemia can be life threatening. High levels of methemoglobinemia in the blood can cause damage to body cells due to lack of oxygen. As a result, the following complications can occur:

  • Seizure
  • Heart attack
  • Comma
  • Death

Methemoglobinemia Prevention

Congenital or inherited methemoglobinemia cannot be prevented because it is caused by genetic factors. If you or your partner has methemoglobinemia, seek genetic counseling when planning to have children.

For acquired methemoglobinemia, prevention can be done by the following things:

  • Avoid consumption of chemical substances or compounds that can cause methemoglobinemia.
  • Perform regular check-ups if required to take certain drugs.
  • If you use well water for drinking, close the well hole tightly so that it is not contaminated with harmful chemical compounds.

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