A Case of Rasburicase-Induced Methemoglobinemia Due to Glucose-6-Phosphate Dehydrogenase Deficiency Treated With Hyperbaric Oxygen therapy

Richert, Mary; Ali, Omer; Stankiewicz, J; Augenstein, Cheryl; Trinidad, Lino Rafael

doi:10.1016/j.chest.2019.08.178

Cited by 3 publications

(1 citation statement)

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“…Patients with a G6PD deficiency are not able to detoxify the hydrogen peroxide, which then starts to oxidize the hemoglobin to methemoglobin. Methylene blue, an agent used for treating methemoglobinemia, should be avoided in patients with G6PD deficiency considering that it is inadequately reduced to its active form, which can lead to hemolysis [15]. As rasburicase-induced methemoglobinemia mainly occurs in individuals with G6PD deficiency, empirical use of methylene blue should be avoided in these individuals.…”

Section: Discussionmentioning

confidence: 99%

Rasburicase-Induced Methemoglobinemia

Ahmed

Sanchez

Norgbe

et al. 2021

Cureus

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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. Methylene blue, an agent used for treating methemoglobinemia, should be avoided in patients with G6PD deficiency. In patients with G6PD deficiency, methylene blue is inadequately reduced to its active form, which then causes the methylene blue to further the oxidize the hemoglobin to methemoglobin that can result in hemolysis.

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Section: Discussionmentioning

confidence: 99%