Acute Favism: Methemoglobinemia May Cause Cyanosis and Low Pulse Oximetry Readings

Leunbach, Tina Lund; Pedersen, Jannik Nedergaard; Trydal, Torleif; Thorgaard, Per; Helgestad, Jon; Rosthøj, Steen

doi:10.3109/08880018.2012.760022

Cited by 7 publications

(9 citation statements)

References 11 publications

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“…Additionally, Leunbach TL et al [ 28 ] reported in 2014 two cases of methemoglobinemia. The first was a 4-year-old Iraqi male admitted with fever, fatigue, AHA, jaundice, and cyanosis with SpO2 74%, which developed two days after fava bean ingestion.…”

Section: Resultsmentioning

confidence: 99%

Favism: Clinical Features at Different Ages

2023

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Favism is a hemolytic disease due to the ingestion of fava beans in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. There is wide inter- and intra-individual variability in the development of hemolytic crisis, and several factors influence it: quantity, quality, ripeness of fava beans, and age of onset. In this narrative review of case reports and case series, we reported the predisposing factors and clinical features for four different age groups classified as follows: pregnant women and infants (i.e., exclusively breastfed children); children, from weaned to 11 years; preadolescents and adolescents, from 11 to 18 years; and adults (18 years and older). Some symptoms developed only in specific age groups: death in infants; visual impairment in children; systolic murmur in infants, children, and adolescents; and renal failure in adults. In youngest children or pregnant women the severity is the highest. Some other symptoms were present in all: jaundice, increased bilirubin, splenomegaly, hepatomegaly, discolored urine, tachycardia, pallor, abdominal pain, malaise, vomit, nausea, and dizziness. Laboratory findings are characterized by anemia, reticulocytosis, elevated bilirubin level, and sometimes urinary urobilinogen and methemoglobinemia. In most cases the symptomatology is self-limited and does not release sequelae, but hospitalization and transfusion are often required.

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Section: Resultsmentioning

confidence: 99%

Favism: Clinical Features at Different Ages

2023

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“…The most frequent cause of this co‐occurrence reported in the literature is the ingestion of fava beans, which can induce methemoglobinemia and potentiate G6PD deficiency simultaneously 3,16‐19 . All the reported cases in the literature are male, with a median age of 6 years (range 1‐56).…”

Section: Discussionmentioning

confidence: 99%

“…Rarely, patients can present with co‐occurrence of methemoglobinemia and G6PD deficiency 3,16‐19 . In such cases, extreme caution is required while administering methylene blue as they do not have sufficient NADPH levels to reduce it.…”

Section: Discussionmentioning

confidence: 99%

Favism‐induced methemoglobinemia in a G6PD deficient male with a subsequent hemolytic cascade, a therapeutic challenge: Case report and review of literature

Ata

Javed

Muthanna

et al. 2021

Clinical Case Reports

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“…Rarely, patients can present with co-occurrence of methemoglobinemia and G6PD deficiency. 3,[16][17][18][19] In such cases, extreme caution is required while administering methylene blue as they do not have sufficient NADPH levels to reduce it. Otherwise, a cascade of oxidative hemolysis ensues secondary to underlying G6PD deficiency, resulting in a vicious cycle of further methemoglobinemia.…”

Section: Discussionmentioning

confidence: 99%

“…11 The most frequent cause of this co-occurrence reported in the literature is the ingestion of fava beans, which can induce methemoglobinemia and potentiate G6PD deficiency simultaneously. 3,[16][17][18][19] All the reported cases in the literature are male, with a median age of 6 years (range 1-56). All of them were newly diagnosed with G6PD deficiency upon presentation with MethHgb.…”

Section: Discussionmentioning

confidence: 99%

Favism induced methemoglobinemia in a G6PD deficient male with a subsequent hemolytic cascade, a therapeutic challenge: case report and review of literature

Ata

Javed

Muthanna

et al. 2020

Preprint

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We report a 56-year-old man with methemoglobinemia and hemolytic anemia, secondary to fava bean ingestion. Methylene blue administration worsened the hemolysis as he was G6PD deficient but not diagnosed before. We have discussed the mechanism of hemolysis in such patients and the management of such cases.Hemolytic anemia, a form of anemia that causes premature rupture of erythrocytes, accounts for five percent of anemias. 1 Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a well-known cause of hemolysis and currently affects around 400 000 000 individuals globally. It has a notable prevalence in African, Asian, and Mediterranean countries. 2 Favism is a common trigger of oxidative stress in G6PD deficient people, which can lead to hemolysis. Additionally, fava bean ingestion can cause methemoglobinemia. 3 Methemoglobin is an abnormal variation in the hemoglobin in which the ferrous (Fe2 + ) iron in heme is oxidized to the ferric (Fe3 + ) state. The condition is usually acquired, secondary to oxidative stress in the body such as favism or infections, but can rarely be congenital. 4 The first-line treatment for methemoglobinemia is methylene blue. However, in G6PD deficient patients, methylene blue can potentiate hemolysis because of its oxidative effects. 3 It is vital to take a detailed history of patients presenting with hemolysis to identify the potential causes and avoid any additional oxidative stress.

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Acute Favism: Methemoglobinemia May Cause Cyanosis and Low Pulse Oximetry Readings

Cited by 7 publications

References 11 publications

Favism: Clinical Features at Different Ages

Favism: Clinical Features at Different Ages

Favism‐induced methemoglobinemia in a G6PD deficient male with a subsequent hemolytic cascade, a therapeutic challenge: Case report and review of literature

Favism induced methemoglobinemia in a G6PD deficient male with a subsequent hemolytic cascade, a therapeutic challenge: case report and review of literature

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