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==Overview==
==Overview==

Revision as of 02:31, 30 April 2018

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

Overview

Congenital (Hereditary) Methemoglobinemia

There are three main congenital conditions that lead to methemoglobinemia:

1. Cytochrome b5 reductase deficiency and pyruvate kinase deficiency

2. G6PD deficiency

3. Presence of abnormal hemoglobin (Hb M)


Acquired or Acute Methemoglobinemia

Most common cause include different oxidant drugs, toxins or chemicals

Epidemiology and Demographics

Epidemiology

In the United States congenital methemoglobinemia is rare. Deficiency of cytochrome b5 reductase endemic only in some Native American tribes like Navajo [1] and Athabaskan Alaskans, and the Yakutsk people in Siberia. [2]

The acquired methemoglobinemia is the most common form, and most cases are related to topical or local anesthetic use during medical procedures.

Demographics

Infants, particularly those younger than 4 months are most susceptible to methemoglobinemia. This is due to the fact that the NADH methemoglobin reductase activity and concentration (the main protective enzyme against oxidative stress) is not fully mature in infants. Both cytochrome b5 reductase deficiency and pyruvate kinase deficiency are autosomal recessive diseases and the Hb M has autosomal dominant pattern of inheritance. On the other hand G6PD deficiency is X-linked, therefore the risk of acquired methemoglobinemia is greater in males. The highest prevalence of G6PD deficiency is observed in the malaria-endemic regions: Sub-Saharan Afria, West Asia and Arabian Peninsula, as well as in people of Mediterranean descent. As a result these populations are at higher risk for acquired methemoglobinemia. [3] [4] [5]


  1. {{J Pediatr. 1964 Dec;65:928-31. HEREDITARY METHEMOGLOBINEMIA DUE TO DIAPHORASE DEFICIENCY IN NAVAJO INDIANS. BALSAMO P, HARDY WR, SCOTT EM. pmid=14244100}}
  2. {{J Pediatr Hematol Oncol. 2017 Jan;39(1):42-45. Enzymopenic Congenital Methemoglobinemia in Children of the Republic of Sakha (Yakutia). Burtseva TE1, Ammosova TN, Protopopova NN, Yakovleva SY, Slobodchikova MP. pmid=27879543 }}
  3. {{Malar J. 2013 Nov 15;12:418. doi: 10.1186/1475-2875-12-418. Spatial distribution of G6PD deficiency variants across malaria-endemic regions. Howes RE1, Dewi M, Piel FB, Monteiro WM, Battle KE, Messina JP, Sakuntabhai A, Satyagraha AW, Williams TN, Baird JK, Hay SI. pmid=24228846 }}
  4. {{ Adv Parasitol. 2013;81:133-201. doi: 10.1016/B978-0-12-407826-0.00004-7. G6PD deficiency: global distribution, genetic variants and primaquine therapy. Howes RE1, Battle KE, Satyagraha AW, Baird JK, Hay SI.pmid=23384623}}
  5. Template:Pmid=1917622

References

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