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  • Met Hemoglobine Mia

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    Himalaya Aggarwal
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    Methemoglobinemia is a condition characterized by abnormal levels of methemoglobin in the blood. Methemoglobin is a form of hemoglobin that is not able to effectively transport oxygen due to iron being in the ferric (Fe3+) state rather than the ferrous (Fe2+) state. Methemoglobinemia can be acquired through exposure to certain drugs and chemicals or can be congenital due to genetic defects affecting the enzymes that normally break down methemoglobin. Symptoms range from cyanosis and fatigue with mild cases to seizures and death in severe cases over 50%. Diagnosis involves analyzing blood spectra and treatment focuses on reducing agents like methylene blue or supportive care with oxygen.

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    Methemoglobinemia is a condition characterized by abnormal levels of methemoglobin in the blood. Methemoglobin is a form of hemoglobin that is not able to effectively transport oxygen due to iron being in the ferric (Fe3+) state rather than the ferrous (Fe2+) state. Methemoglobinemia can be acquired through exposure to certain drugs and chemicals or can be congenital due to genetic defects affecting the enzymes that normally break down methemoglobin. Symptoms range from cyanosis and fatigue with mild cases to seizures and death in severe cases over 50%. Diagnosis involves analyzing blood spectra and treatment focuses on reducing agents like methylene blue or supportive care with oxygen.

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    16 views2 pages

    Met Hemoglobine Mia

    Uploaded by

    Himalaya Aggarwal
    Methemoglobinemia is a condition characterized by abnormal levels of methemoglobin in the blood. Methemoglobin is a form of hemoglobin that is not able to effectively transport oxygen due to iron being in the ferric (Fe3+) state rather than the ferrous (Fe2+) state. Methemoglobinemia can be acquired through exposure to certain drugs and chemicals or can be congenital due to genetic defects affecting the enzymes that normally break down methemoglobin. Symptoms range from cyanosis and fatigue with mild cases to seizures and death in severe cases over 50%. Diagnosis involves analyzing blood spectra and treatment focuses on reducing agents like methylene blue or supportive care with oxygen.

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    NOTES

    NOTES
    METHEMOGLOBINEMIA

    METHEMOGLOBINEMIA
    osms.it/methemoglobinemia
    ▪ Industrial chemicals
    PATHOLOGY & CAUSES ▫ Aniline dyes, chlorates, bromates,
    nitrates
    ▪ ↑ methemoglobin levels in blood > 10%
    ▫ Normal methemoglobin level < 1% Congenital methemoglobinemia
    ▪ Methemoglobin ▪ Recessive gene → enzyme diaphorase I
    ▫ Hemoglobin form: contains ferric (Fe3+) deficiency → inefficient methemoglobin ↓
    iron → ↓ oxygen affinity → accumulation
    ▫ Overwhelming oxidative stress (in red ▪ Abnormal hemoglobin variants (HbM/HbH)
    blood cells) → iron oxidation within → hemoglobin not enzymatic-reduction
    heme (Fe2+ → Fe3+) → hemoglobin amenable
    converted to methemoglobin ▪ Diaphorase I cofactor deficiency
    ▫ Oxygen binding → ↑ affinity in ▫ Impaired upstream enzymes →
    remaining heme sites that may have insufficient diaphorase I cofactors
    been in ferrous (Fe2+) state in heme production → impaired enzymatic
    tetramer → left shift in oxygen curve → reduction
    overall oxygen to tissue release ability ↓ ▫ Pyruvate kinase deficiency
    → tissue hypoxia ▫ Glucose-6-phosphate dehydrogenase
    ▪ Healthy cells deficiency
    ▫ Spontaneous methemoglobin
    conversion rapidly ↓ by protective
    enzymes SIGNS & SYMPTOMS
    ▫ Nicotinamide adenine dinucleotide-
    reduced (NADH) methemoglobin ▪ Arterial blood may develop bluish/
    reductase (diaphorase I) chocolate-brown tinge
    ▫ Nicotinamide adenine dinucleotide ▪ Healthy individuals
    phosphate (NADPH) methemoglobin ▫ Symptoms may only manifest at
    reductase methemoglobin levels > 15%
    ▫ Ascorbic acid ▫ Cyanosis → dyspnea, mental status
    ▫ Glutathione enzyme system change, headache, fatigue, exercise
    intolerance, dizziness
    ▪ Severe methemoglobinemia (> 50%) →
    TYPES seizure, coma, death
    Acquired methemoglobinemia
    ▪ ↑ methemoglobin formation
    ▪ Drugs
    ▫ Antibiotics, local anesthetics,
    antiemetics

    OSMOSIS.ORG 413
    DIAGNOSIS TREATMENT
    DIAGNOSTIC IMAGING MEDICATIONS
    ▪ Specific
    Co-oximetry
    ▫ Methylene blue: intravenous reducing
    ▪ Analyses blood-spectrum absorption → agent → reduces heme group from
    methemoglobin peak absorbance at 631nm methemoglobin → hemoglobin

    LAB RESULTS OTHER INTERVENTIONS


    ▪ Arterial blood gas ▪ Supplemental oxygen
    ▫ Clinical cyanosis in normal arterial PO2 ▪ Vitamin C (ascorbic acid) may improve
    presence cyanosis in chronic cases
    ▪ Enzyme assays
    ▫ Enzyme assays for specific enzymes
    involved in maintaining hemoglobin in
    reduced state may be utilized

    414 OSMOSIS.ORG

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