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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Methemoglobinemia causes

Introduction

Overview

Overview

Methemoglobinemia may be caused by either congenital or acquired conditions.

Causes

Causes

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

1. Drug Induced

• Anesthetics[3] like benzocaine[4], lidocaine[5], prilocaine[6]

• Methylene blue

• Nitric oxide

• Amyl Nitrate

• Nitroglycerin

• Antimalarial drugs like Primaquine phosphate (in nicotinamide adenine dinucleotide (NADH) methemoglobin reductase deficient individuals)

• Rasburicase [7]

• Sulfasalazine

• Dapsone

• Trimethoprim

• Sulfonamides

• Aniline dyes[8]

• Metoclopramide

• Chlorates and Bromates

2. Contaminated well water (in premature infants and infants younger than 4 months) [9] [10]

3. Solid foods (not well cooked vegetables high in nitrates in premature infants and infants younger than 4 months) [11] [12]

References

References

  1. ↑ Hall AH, Kulig KW, Rumack BH (1986). “Drug- and chemical-induced methaemoglobinaemia. Clinical features and management”. Med Toxicol. 1 (4): 253–60. PMID 3537620.
  2. ↑ do Nascimento TS, Pereira RO, de Mello HL, Costa J (2008). “Methemoglobinemia: from diagnosis to treatment”. Rev Bras Anestesiol. 58 (6): 651–64. PMID 19082413.
  3. ↑ Faust AC, Guy E, Baby N, Ortegon A (2018). “Local Anesthetic-Induced Methemoglobinemia During Pregnancy: A Case Report and Evaluation of Treatment Options”. J Emerg Med. 54 (5): 681–684. doi:10.1016/j.jemermed.2018.01.039. PMID 29519718.
  4. ↑ Rodriguez LF, Smolik LM, Zbehlik AJ (1994). “Benzocaine-induced methemoglobinemia: report of a severe reaction and review of the literature”. Ann Pharmacother. 28 (5): 643–9. doi:10.1177/106002809402800515. PMID 8069004.
  5. ↑ Gay HC, Amaral AP (2018). “Acquired Methemoglobinemia Associated with Topical Lidocaine Administration: A Case Report”. Drug Saf Case Rep. 5 (1): 15. doi:10.1007/s40800-018-0081-4. PMC 5889764. PMID 29627919.
  6. ↑ Shamriz O, Cohen-Glickman I, Reif S, Shteyer E (2014). “Methemoglobinemia induced by lidocaine-prilocaine cream”. Isr Med Assoc J. 16 (4): 250–4. PMID 24834764.
  7. ↑ Khan M, Paul S, Farooq S, Oo TH, Ramshesh P, Jain N (2017). “Rasburicase-Induced Methemoglobinemia in a Patient with Glucose-6- Phosphate Dehydrogenase Deficiency”. Curr Drug Saf. 12 (1): 13–18. doi:10.2174/1574886312666170111151246. PMID 28078984.
  8. ↑ Messmer AS, Nickel CH, Bareiss D (2015). “P-chloroaniline poisoning causing methemoglobinemia: a case report and review of the literature”. Case Rep Emerg Med. 2015: 208732. doi:10.1155/2015/208732. PMC 4377359. PMID 25861488.
  9. ↑ Brunato F, Garziera MG, Briguglio E (2003). “A severe methaemoglobinemia induced by nitrates: a case report”. Eur J Emerg Med. 10 (4): 326–30. doi:10.1097/01.mej.0000103472.32882.db. PMID 14676514.
  10. ↑ [www.epa.gov/dwstandardsregulations]
  11. ↑ [www.fda.gov/Drugs/DrugSafety/ucm250024.htm]
  12. ↑ [www.fda.gov/forconsumers/consumerupdates/ucm306062.htm]

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