METHEMOGLOBINEMIA

TYPES

The two types of methemoglobinemia are acquired and congenital.

• Acquired Methemoglobinemia

Also called acute methemoglobinemia, acquired methemoglobinemia is considered as the most common type of this blood disorder. Exposure to particular foods, medicines, and chemicals causes acquired methemoglobinemia.

Individuals who have a genetic form of the illness are more likely to develop the acquired methemoglobinemia. If not treated right away, it can cause death.

Infants and adults can get this blood disease as well.

Infants

Infants are more vulnerable than adults. Here are some of the leading causes of acquired methemoglobinemia for babies.

• Benzocaine 

Benzocaine is present in products that can ease the sore gums of babies due to teething. With this, the U.S. Food and Drug Administration advises parents to avoid using these products on kids younger than two years old.

• Polluted water from the well

Polluted well water is more likely to have too many nitrates. Babies below six years old may get acquired methemoglobinemia from contaminated water. When the nitrates and bacteria in an infant’s digestive system combine, it causes methemoglobinemia.

• Solid foods

Sometimes, home-cooked solid foods can have excess nitrates. Foods such as carrots, green beans, and spinach can be dangerous for babies below four months old.

It is one of the reasons why pediatricians instruct parents to avoid giving solid foods to infants.

Adults

Adults may develop methemoglobinemia after undergoing a medical procedure that used topical anesthetics like lidocaine and prilocaine.

• Congenital methemoglobinemia

Genetic problems inherited from your parents can cause congenital methemoglobinemia. This genetic disorder results in an enzyme deficiency. The primary role of this particular enzyme is to transform methemoglobin to hemoglobin.

Here are the three types of congenital methemoglobinemia:

• Type 1

It is the most well-known type. The only symptom of this is cyanosis, and it only affects the red blood cells. People who have this condition may have bluish-tinted skin for the rest of their lives. Also, people who have this are more likely to develop the acquired type.

• Hemoglobin M disease

A genetic mutation causes this type. It is believed that Hemoglobin M disease didn’t come from your parents. People who have it don’t show symptoms and don’t require remedy.

• Type 2

It is the rarest type among the three. All cells are affected by this type, and it can result in severe developmental problems.

SYMPTOMS 

Symptoms vary depending on the type of this disease. However, the major symptoms are having bluish skin or cyanosis and brown-colored blood. 

This disease is also called the ‘baby blue syndrome’ because of cyanosis.

The increase of methemoglobin levels also leads to severe symptoms like loss of consciousness, rapid heart rate, and shortness of breath.

DIAGNOSIS

Your doctor will order you to do these tests in order to diagnose this kind of disease:

• CBC
• Enzymes test
• Blood color examination
• Test to check your blood levels of nitrate and other drugs
• Must undergo pulse oximetry, to check the oxygen saturation in your blood.
• Sequencing your DNA

TREATMENT

Methemoglobinemia might be considered a medical emergency. The first treatment of this disease is the infusion of the drug methylene blue. This kind of medication helps the patient quickly. Patients with a congenital type of methemoglobinemia can’t use methylene blue. Additionally, a patient who does not respond to methylene blue needs a blood transfusion. Thus, patients will receive aspirin therapy if he/she has type 1 hereditary methemoglobinemia.