Occurrence of Methemoglobinemia due to COVID-19: A Case Report

Kashari, Ohoud; Alsamiri, Salihah A; Zabbani, Fatimah M; Musalli, Dania I; Ibrahim, Ahmed M. S.

doi:10.7759/cureus.23155

Cited by 4 publications

(20 citation statements)

References 16 publications

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“…A case reported described such an event following hepatitis E virus infection in a patient with G6PD deficiency [19]. Only three cases of acute hemolysis and methemoglobinemia were reported in G6PD-deficient patients with COVID-19 infection, and no other identified trigger [14][15][16]. Here, we report a new case of late-onset G6PD-associated hemolysis in an adult with concurrent methemoglobinemia after COVID-19 infection.…”

Section: Discussionmentioning

confidence: 73%

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Co-Occurring Hemolysis and Methemoglobinemia After COVID-19 Infection in Patient With G6PD Deficiency

Malakah¹,

Baghlaf²,

Alsulami³

2023

Cureus

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Hemolytic anemia and methemoglobinemia are known complications in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. They can be elicited by various oxidative stressors.Here we report a case of an adult with the first episode of G6PD deficiency associated hemolysis and methemoglobinemia after acquiring COVID-19 infection, who had no recent exposure to oxidative drugs or fava beans. A 52-year-old gentleman known to have myocardial bridging on aspirin and beta-blocker, with no other medical illnesses, developed anemia symptoms, jaundice, and hypoxia after contracting COVID-19 infection. Further laboratory work revealed non-immune hemolytic anemia, methemoglobinemia, and a positive G6PD screen test. He was treated conservatively with a blood transfusion, and his oxygen saturation improved thereafter.With the widespread COVID-19 infection and its morbidity worldwide, it is crucial to consider methemoglobinemia in the differential diagnosis of hypoxia. Testing for G6PD is an essential next step in such cases, as starting methylene blue in G6PD deficiency can worsen hemolysis. Apart from COVID-19, there is no other identified trigger for the acute event in this patient. It is not known whether COVID-19 infection alone is enough to result in G6PD deficiency-associated hemolysis and methemoglobinemia simultaneously.

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Section: Discussionmentioning

confidence: 73%

“…Most of the cases were associated with the use of hydroxychloroquine [11][12][13], but only two cases found no clear trigger for the acute episode in adults [14,15]. A recently reported case of co-occurrence of hemolysis and methemoglobinemia in pediatric patients with COVID-19 in the absence of triggering medication [16].…”

Section: Introductionmentioning

confidence: 99%

Co-Occurring Hemolysis and Methemoglobinemia After COVID-19 Infection in Patient With G6PD Deficiency

Malakah¹,

Baghlaf²,

Alsulami³

2023

Cureus

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“…In addition, the combined effect of the destruction of membrane structures and the presence of a higher degree of oxidative stress in the RBCs of patients with COVID-19 [ 20 ], leads to the formation of metHb [ 281 , 282 , 283 , 284 , 285 , 286 ], unable to carry oxygen [ 88 , 90 , 287 , 288 ] and thereby the initiator of encephalopathy, the clinical manifestations of which (depending on the degree of metHb accumulation) [ 289 ] can vary from asymptomatic to severe hypoxia that does not respond to supplemental oxygen therapy, leading to changes in mental status, coma, and death [ 290 , 291 , 292 ].…”

Section: Erythrocyte Metabolic Disturbances As An Indicator Of Mental...mentioning

confidence: 99%

Erythrocytes Functionality in SARS-CoV-2 Infection: Potential Link with Alzheimer’s Disease

Kosenko

Tikhonova

Alilova

et al. 2023

IJMS

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Coronavirus disease 2019 (COVID-19) is a rapidly spreading acute respiratory infection caused by SARS-CoV-2. The pathogenesis of the disease remains unclear. Recently, several hypotheses have emerged to explain the mechanism of interaction between SARS-CoV-2 and erythrocytes, and its negative effect on the oxygen-transport function that depends on erythrocyte metabolism, which is responsible for hemoglobin-oxygen affinity (Hb-O2 affinity). In clinical settings, the modulators of the Hb-O2 affinity are not currently measured to assess tissue oxygenation, thereby providing inadequate evaluation of erythrocyte dysfunction in the integrated oxygen-transport system. To discover more about hypoxemia/hypoxia in COVID-19 patients, this review highlights the need for further investigation of the relationship between biochemical aberrations in erythrocytes and oxygen-transport efficiency. Furthermore, patients with severe COVID-19 experience symptoms similar to Alzheimer’s, suggesting that their brains have been altered in ways that increase the likelihood of Alzheimer’s. Mindful of the partly assessed role of structural, metabolic abnormalities that underlie erythrocyte dysfunction in the pathophysiology of Alzheimer’s disease (AD), we further summarize the available data showing that COVID-19 neurocognitive impairments most probably share similar patterns with known mechanisms of brain dysfunctions in AD. Identification of parameters responsible for erythrocyte function that vary under SARS-CoV-2 may contribute to the search for additional components of progressive and irreversible failure in the integrated oxygen-transport system leading to tissue hypoperfusion. This is particularly relevant for the older generation who experience age-related disorders of erythrocyte metabolism and are prone to AD, and provide an opportunity for new personalized therapies to control this deadly infection.

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“…Deliberate or premeditated poisoning is commonly linked to antecedent psychiatric illness, personal, and societal stresses. Timely intensive management is crucial to prevent serious complications and mortality 1 …”

Section: Introductionmentioning

confidence: 99%

“…An oxidizing nitrite chemical, nitrobenzene (nitrobenzol or oil of mirbane), is frequently found in metal polishes, soaps, shoe polishes, synthetic rubber, paints, dyes, and printing. Inhaling, consuming, or coming into contact with nitrobenzene‐containing products can expose members of the public to nitrobenzene 1–3 …”

Section: Introductionmentioning

confidence: 99%

Acquired methemoglobinemia due to nitrobenzene poisoning: An unusual acquaintance

Bhatta,

Awasthi

2024

Clinical Case Reports

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Key Clinical MessageNitrobenzene poisoning is a rare yet life‐threatening contention. The ensuing acute methemoglobinemia has a high fatality rate, hence early prompt intervention is required. Methylene blue (intravenous or oral) and ascorbic acid are the cornerstones of management. They must be administered to suspected patients without tardiness.AbstractAn aromatic organic chemical used in paints and the printing industry is nitrobenzene. Its poisoning causes potentially fatal methemoglobinemia. One aspect of its management involves reducing the iron moiety from its ferric to ferrous form by administering intravenous methylene blue. A 23‐year‐old man who had deliberately consumed nitrobenzene presented to us with a history of headache and vomiting. He was diagnosed to have methemoglobinemia on the basis of clinical grounds and was managed successfully with intravenous methylene blue and vitamin C.

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Occurrence of Methemoglobinemia due to COVID-19: A Case Report

Cited by 4 publications

References 16 publications

Co-Occurring Hemolysis and Methemoglobinemia After COVID-19 Infection in Patient With G6PD Deficiency

Co-Occurring Hemolysis and Methemoglobinemia After COVID-19 Infection in Patient With G6PD Deficiency

Erythrocytes Functionality in SARS-CoV-2 Infection: Potential Link with Alzheimer’s Disease

Acquired methemoglobinemia due to nitrobenzene poisoning: An unusual acquaintance

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