Methemoglobinemia differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aksiniya Stevasarova, M.D.

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Overview

Depending on the levels of MetHb in the blood we can observe different symptoms as follows: MetHb of 15% presents with skin and blood color changes. Levels above 15% will result in hypoxia and levels above 70% can lead to death.

There are several conditions that can present similar to methemoglobinemia. Note that the hypoxia in methemogobinemia will be unresponsive to oxygen treatment, in comparison to cardiac and pulmonary cause of hypoxia. Worth mentioning is also that high doses of antidote treatment for methemogobinemia (Methylene blue) can also cause cyanotic discoloration of the skin, but this does not mean that the treatment is not working.

Differential Diagnosis

• Heart failure

• Pulmonary embolism

• Polycythemia

• Anemia

• Rasbirucase (Rx Tumor Lysis Syndrome)

• Metabolic Acidosis

• Methylene Blue treatment

• Sulfhemoglobin

• Asthma