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Cureus 2021 Apr 10;13(4):e14406. Epub 2021 Apr 10.

Internal Medicine, Creighton University School of Medicine, Omaha, USA.

Methemoglobinemia occurs as iron in heme is oxidized to its ferric state, resulting in a decreased ability of hemoglobin to bind and release oxygen. Rasburicase is a recombinant urate-oxidase enzyme used in the prevention of tumor lysis syndrome. Methemoglobinemia can occur as a rare complication of treatment with rasburicase, primarily in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Read More

Am J Med Sci 2021 May 10. Epub 2021 May 10.

Department of Clinical Haematology and Stem Cell Transplant, Army Hospital (Research & Referral), New Delhi, India.

Clin Case Rep 2021 Apr 20;9(4):2048-2052. Epub 2021 Feb 20.

Department of Hematology National Center for Cancer Care & Research Hamad Medical Corporation Doha Qatar.

The co-occurrence of acute hemolysis and methemoglobinemia secondary to favism in G6PD deficient individuals is rare. Identifying it promptly is of high clinical significance as treating methemoglobinemia (with methylene blue) can worsen hemolysis. Read More

J Clin Pharm Ther 2021 Apr 27. Epub 2021 Apr 27.

The Canberra Hospital, Canberra, ACT, Australia.

What Is Known And Objective: Methaemoglobinaemia is an altered state of haemoglobin caused by a variety of therapeutics which impairs tissue oxygenation. There are numerous cases in the literature of methaemoglobinaemia induced iatrogenically in a hospital environment. This is a case of methaemoglobinaemia induced by an over-the-counter topical local anaesthetic in a patient with widespread skin lesions. Read More

Natl Med J India 2020 May-Jun;33(3):149-151

Department of Transfusion Medicine, Medanta-The Medicity, Sector 38, Gurugram 122001, Haryana, India.

Methaemoglobinaemia in G6PD deficiency can be managed by oxidizing agents such as methylene blue and red cell exchange (RCE). We describe a G6PD-deficient patient who presented with oxidative stress with methaemoglobinaemia and was successfully managed with automated-RCE. At presentation, the patient had anaemia, was restless, was tired and had dyspnoea. Read More

Cureus 2021 Mar 24;13(3):e14079. Epub 2021 Mar 24.

Emergency Department, Imam Abdulrahman Bin Faisal University, Dammam, SAU.

Methemoglobinemia is a blood disorder in which there is an elevated level of methemoglobin. In contrast to normal hemoglobin, methemoglobin does not bind to oxygen, which leads to functional anemia. The signs of methemoglobinemia often overlap with other cardiovascular and pulmonary diseases, with cyanosis being the key sign of methemoglobinemia. Read More

BMJ Case Rep 2021 Apr 23;14(4). Epub 2021 Apr 23.

Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA.

Methaemoglobinemia is an uncommon but potentially life-threatening complication of topical benzocaine use that requires prompt identification in patients who undergo transoesophageal echocardiography (TEE). In this case, a 21-year-old patient who had sustained a stroke with residual right-sided weakness a few days prior to presentation underwent TEE to evaluate for intracardiac shunt. She required intubation as part of her poststroke care with some instrumentation to the posterior oropharynx. Read More

J Am Soc Echocardiogr 2021 Apr 16. Epub 2021 Apr 16.

Division of Cardiovascular Ultrasound, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.

Indian J Dermatol Venereol Leprol 2021 Mar 12:1-4. Epub 2021 Mar 12.

Department of Endocrinology, Diabetes and Metabolism Christian Medical College, Vellore, Tamil Nadu, India.

Background: Dapsone treatment may reduce HbA1c levels in patients with diabetes.

Aims: To assess the prevalence and characteristics of dapsone associated reduction of HbA1c in patients with Hansen's disease.

Methods: A retrospective data review of outpatient and inpatient charts of consecutive patients with Hansen's disease and type 2 diabetes mellitus was conducted over two years from January 2014 to January 2016 at the Department of Dermatology, CMC Vellore, India. Read More

Handchir Mikrochir Plast Chir 2021 Apr 16. Epub 2021 Apr 16.

Spital Thurgau AG, Hand- und Plastische Chirurgie.

Aetiologically, prilocaine-induced methaemoglobinaemia is a rare form of acquired methaemoglobinaemia, which occurs rarely in the first place. The following report highlights a potentially dangerous complication arising after application of prilocaine during liposuction.A young female visited the Accident and Emergency Department following a pre-syncopal fall. Read More

Medicine (Baltimore) 2021 Apr;100(15):e25522

Division of Cardiovascular Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan.

Rationale: Severe methemoglobinemia (Met-Hb) is rare. The delayed diagnosis and treatment often cause further damage. The management of cellular hypoxemia is challenging and the use of extra-corporeal membrane oxygenation (ECMO) has never been reported. Read More

Rev Med Chil 2020 Dec;148(12):1838-1843

Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Methemoglobinemia is a rare condition with serious consequences if not diagnosed. We report the case of a 64-year-old woman with a history of allergy to sulfa drugs and a recent diagnosis of a small vessel vasculitis (ANCA-p) who started induction therapy with corticosteroids and rituximab. Due to the need for infectious prophylaxis, and considering her history, dapsone was administered instead of cotrimoxazole after ruling out glucose-6-phosphate dehydrogenase deficiency. Read More

Acta Dermatovenerol Croat 2020 Dec;28(4):249-250

Hisayoshi Imanishi, MD, PhD, Division of Dermatology, Daito Central Hospital, 2-1-11 Ono, Daito, Osaka 574-0042, Japan;

Dear Editor, Dapsone is a dual-function drug with antimicrobial and antiprotozoal effects and anti-inflammatory features (1). In dermatology, it is a first choice for conditions such as leprosy, IgA pemphigus, dermatitis herpetiformis, and linear IgA bullous dermatosis, or an adjunctive treatment for, e.g. Read More

Animals (Basel) 2021 Mar 24;11(4). Epub 2021 Mar 24.

Department of Poultry Science, University of Georgia, Athens, GA 30605, USA.

Nitrocompounds are derivatives of hydrocarbons, alcohols, fatty acids, and esters, consisting one or more nitro functional groups. Either natural sources of nitrocompounds or synthetic chemicals have been applied in animal diets to investigate their effects on economic animals, since conjugates of 3-nitropropanol and 3-nitropropionic acid were isolated from In this review, emphasis will be placed on nitrocompounds' antimicrobial activity, toxicity, metabolisms and mechanisms of actions. Nitrocompounds can be metabolized by ruminal microbials, such as , or alcohol dehydrogenase in the liver. Read More

Clin Toxicol (Phila) 2021 Mar 31:1-6. Epub 2021 Mar 31.

Toxikon Consortium, Chicago, IL, USA.

Introduction: Sodium nitrite is an oxidizing agent capable of producing profound methemoglobinemia. Large quantities of sodium nitrite can be purchased online, and recent literature has identified several cases of intentional self-poisoning, including multiple cases of mortality. This has raised concern that intentional sodium nitrite poisoning and resultant severe methemoglobinemia may be increasing in incidence and could represent a substantial public health threat. Read More

J Vet Intern Med 2021 Mar 28;35(2):1203. Epub 2021 Jan 28.

CMAJ Open 2021 Jan-Mar;9(1):E252-E260. Epub 2021 Mar 17.

School of Nursing (Sushko), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Division of General Pediatrics (Litalien), Department of Pediatrics, and the Rosalind & Morris Goodman Family Pediatric Formulations Centre, Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Pharmacy (Ferruccio), Hamilton Health Sciences, Hamilton, Ont.; Rosalind & Morris Goodman Family Pediatric Formulations Centre (Gilpin), Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Mazer-Amirshahi), MedStar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC; Division of Pediatric Hematology/Oncology (Chan), McMaster Children's Hospital, McMaster University, Hamilton, Ont.; Division of Clinical Pharmacology (van den Anker), Department of Pediatrics, Children's National Hospital, Washington, DC; Division of Paediatric Pharmacology and Pharmacometrics (van den Anker), University Children's Hospital, University of Basel, Basel, Switzerland; Division of Neonatology (Lacaze-Masmonteil), Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alta.; Division of Neonatology (Samiee-Zafarghandy), Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ont.

Background: Topical nitroglycerin (TNG) ointment has been used for almost 3 decades to treat neonatal peripheral tissue ischemia, but this product is now no longer being produced by its Canadian manufacturer. Our aim was to investigate the efficacy and safety of TNG products in newborns in neonatal intensive care units.

Methods: In this systematic review we searched Embase, CINAHL, MEDLINE, PubMed and Web of Science from inception to April 2020 for studies on the use of TNG products (TNG ointment, TNG spray, glyceryl trinitrate [GTN] patch) for the treatment of neonatal tissue ischemia. Read More

BMJ Case Rep 2021 Mar 16;14(3). Epub 2021 Mar 16.

Department of Hematology and Oncology, William Beaumont Hospital, Royal Oak, Michigan, USA

We report a case of a 91-year-old Caucasian woman with a history of chronic lymphocytic leukaemia who developed acute hypoxic respiratory failure (AHRF) requiring intubation for less than 24 hours after receiving rasburicase. Laboratory workup was significant for methemoglobinemia and acute anaemia, and blood film demonstrated evidence of oxidative haemolysis with bite cells. The patient was given a presumptive diagnosis of glucose-6-phosphate dehydrogenase (G6PD) deficiency and was managed conservatively with successful resolution of AHRF and stabilisation of haemoglobin level. Read More

J Infect Chemother 2021 Jun 13;27(6):924-928. Epub 2021 Mar 13.

Department of Infectious Diseases, Division of Parasitology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan. Electronic address:

Treatment of intractable Pneumocystis jirovecii pneumonia (PCP) patients with primaquine (PQ) in combination with clindamycin (CLDM) was conducted by the Research Group on Chemotherapy of Tropical Diseases (RG-CTD), as a kind of compassionate use. Primaquine was not nationally licensed at the time but imported by RG-CTD for the use in a clinical research to investigate safety and efficacy in malaria treatment. Eighteen Japanese adult patients thus treated were analyzed. Read More

Int J Pediatr Adolesc Med 2021 Mar 17;8(1):52-54. Epub 2020 Jan 17.

College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

Recessive congenital methemoglobinemia (RCM) is a rare neurological disorder caused by a deficiency in NADH-CYB5R. RCM has two main types I&II, with cyanosis being the hallmark feature in both. Type-I is a mild form, with cyanosis being the only feature. Read More

A A Pract 2021 Mar 8;15(3):e01395. Epub 2021 Mar 8.

From the Department of Anesthesiology, Sidra Medicine, Doha, Qatar.

Congenital methemoglobinemia is a rare disease that is easily overlooked in its mild form. It can lead to tissue hypoxia as methemoglobin does not possess oxygen-carrying capacity. Its management approach depends on the severity of the symptoms, methemoglobin level, and associated medical conditions. Read More

Med Sci (Basel) 2021 Feb 16;9(1). Epub 2021 Feb 16.

IIAIGC Study Center, Burlington, VT 05408, USA.

This short note presents previous research data supporting a pilot study of metronomic dapsone during the entire course of glioblastoma treatment. The reviewed data indicate that neutrophils are an integral part of human glioblastoma pathophysiology, contributing to or facilitating glioblastoma growth and treatment resistance. Neutrophils collect within glioblastoma by chemotaxis along several chemokine/cytokine gradients, prominently among which is interleukin-8. Read More

BMJ Case Rep 2021 Mar 1;14(3). Epub 2021 Mar 1.

Department of Obstetrics and Gynecology, Orlando Health Corp, Orlando, Florida, USA

Methaemoglobinaemia is a life-threatening condition that results from increased methaemoglobin production. As methaemoglobin is unable to reversibly bind to oxygen potentially lethal hypoxia and functional anaemia can occur. Benzocaine can be used as a topical anaesthetic and can be found in many nonprescription preparations marketed for self-application. Read More

Pediatr Rev 2021 Mar;42(3):164-166

Children's Hospital of Georgia at Augusta University, Augusta, GA.

Arch Dis Child 2021 Feb 25. Epub 2021 Feb 25.

Department of Paediatrics, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan.