Methemoglobinemia differential diagnosis: Difference between revisions
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*Methemoglobinemia must be differentiated from other diseases that cause [[hypoxia]] and [[cyanosis]], such as [[heart failure]], [[pulmonary embolism]], [[polycythemia]], [[anemia]], ecc. | *Methemoglobinemia must be differentiated from other diseases that cause [[hypoxia]] and [[cyanosis]], such as [[heart failure]], [[pulmonary embolism]], [[polycythemia]], [[anemia]], ecc. | ||
== | ====Differentiating Methemoglobinemia from other Diseases==== | ||
*Methemoglobinemia can present with similar signs and symptoms of other conditions causing hypoxia (as listed below). Note that the [[hypoxia]] in [[methemogobinemia]] will be unresponsive to [[oxygen]] treatment, in comparison to cardiac and pulmonary causes of [[hypoxia]]. | |||
Note that the [[hypoxia]] in [[methemogobinemia]] will be unresponsive to [[oxygen]] treatment, in comparison to cardiac and pulmonary causes of [[hypoxia]]. | |||
• [[Heart failure]] | • [[Heart failure]] | ||
| Line 17: | Line 15: | ||
• [[Pulmonary embolism]] | • [[Pulmonary embolism]] | ||
• [[Polycythemia]] | • [[Polycythemia]]<ref>{{Hematol Rep. 2018 Mar 2;10(1):7221. doi: 10.4081/hr.2018.7221. eCollection 2018 Mar 2. | ||
Congenital methemoglobinemia misdiagnosed as polycythemia vera: Case report and review of literature. | |||
Soliman DS1,2, Yassin M3. PMID: 29721250 }}</ref> | |||
• [[Anemia]] | • [[Anemia]] | ||
• [[Rasbirucase]] (Rx [[Tumor Lysis Syndrome]]) | • [[Rasbirucase]] (Rx [[Tumor Lysis Syndrome]]) <ref>{{Curr Drug Saf. 2017;12(1):13-18. doi: 10.2174/1574886312666170111151246. | ||
Rasburicase-Induced Methemoglobinemia in a Patient with Glucose-6- Phosphate Dehydrogenase Deficiency. | |||
Khan M, Paul S, Farooq S, Oo TH, Ramshesh P, Jain N1. PMID: 28078984 }}</ref> | |||
• [[Metabolic Acidosis]] | • [[Metabolic Acidosis]] | ||
• [[Methylene Blue]] | • [[Methylene Blue treatment]] | ||
• [[Sulfhemoglobin]] | • [[Sulfhemoglobin]] | ||
• [[Asthma]] | • [[Asthma]] | ||
*High doses of [[antidote treatment]] for [[methemogobinemia]] - ([[Methylene blue]]) can also cause [[cyanotic discoloration of the skin]] as a side effect, but this should not lead you into thinking that the treatment is inefficient. <ref>{{Rev Bras Anestesiol. 2008 Nov-Dec;58(6):651-64. Methemoglobinemia: from diagnosis to treatment. [Article in English, Portuguese] do Nascimento TS1, Pereira RO, de Mello HL, Costa J. pmid=19082413}}</ref> | |||
*Depending on the levels of [[MetHb]] in the [[blood]] we can observe different clinical presentation as follows: | |||
*MetHb levels of 15% lead to skin and blood color (chocolate-brown) changes . | |||
*MetHb levels above 15% lead to [[hypoxia]]. | |||
*MetHb levels above 70% lead to death. | |||
==References== | ==References== | ||
Revision as of 13:20, 15 May 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
- Methemoglobinemia must be differentiated from other diseases that cause hypoxia and cyanosis, such as heart failure, pulmonary embolism, polycythemia, anemia, ecc.
Differentiating Methemoglobinemia from other Diseases
- Methemoglobinemia can present with similar signs and symptoms of other conditions causing hypoxia (as listed below). Note that the hypoxia in methemogobinemia will be unresponsive to oxygen treatment, in comparison to cardiac and pulmonary causes of hypoxia.
• Anemia
• Rasbirucase (Rx Tumor Lysis Syndrome) [2]
• Asthma
- High doses of antidote treatment for methemogobinemia - (Methylene blue) can also cause cyanotic discoloration of the skin as a side effect, but this should not lead you into thinking that the treatment is inefficient. [3]
- Depending on the levels of MetHb in the blood we can observe different clinical presentation as follows:
- MetHb levels of 15% lead to skin and blood color (chocolate-brown) changes .
- MetHb levels above 15% lead to hypoxia.
- MetHb levels above 70% lead to death.
References
- ↑ {{Hematol Rep. 2018 Mar 2;10(1):7221. doi: 10.4081/hr.2018.7221. eCollection 2018 Mar 2. Congenital methemoglobinemia misdiagnosed as polycythemia vera: Case report and review of literature. Soliman DS1,2, Yassin M3. PMID: 29721250 }}
- ↑ {{Curr Drug Saf. 2017;12(1):13-18. doi: 10.2174/1574886312666170111151246. Rasburicase-Induced Methemoglobinemia in a Patient with Glucose-6- Phosphate Dehydrogenase Deficiency. Khan M, Paul S, Farooq S, Oo TH, Ramshesh P, Jain N1. PMID: 28078984 }}
- ↑ {{Rev Bras Anestesiol. 2008 Nov-Dec;58(6):651-64. Methemoglobinemia: from diagnosis to treatment. [Article in English, Portuguese] do Nascimento TS1, Pereira RO, de Mello HL, Costa J. pmid=19082413}}