Persistent Cyanosis in a 4 Month Old Infant with Severe Pneumonia and Haemoglobin M

Abstract

M haemoglobinaemia is a rare cause of persistant cyanosis. We report a four months old infant who suffered from severe pneumonia and respiratory distress syndrome. After return of normal respiration, cyanosis persisted. Oxygen saturation on pulse oximetry never exceeded 85%. Finally, we succeeded in isolating a haemoglobin M Saskatoon. HbM Saskatoon is normally a harmless variant. However, in conjunction with severe pneumonia, we assume that it did not only affect clinical evaluation, but also exacerbated pneumonia by reducing the oxygen binding capacity.

First Observation of Hemoglobin M Saskatoon (�63 (E7) His>Tyr(C-T)) in the Iraqi Population

“…Hemoglobin M Saskatoon (ß63 His>Tyr(C-T)) is a rare hemoglobin variant that was first reported in Japan, fol- lowed by the US, Indonesia, Algeria, Russia, India, and Germany [1,2,3,4,5,6,7,8]. It was also reported in combination with another variant—Hb Hamilton [9]; however, it has yet to reported in the Turkish population [10,11].…”

Hemolytic Anemia and Methemoglobinemia in a Preterm Baby as a Complication of Antenatal Intraamnial Injection of Toluidine Blue

“…After reduction of the PiP to 15 cm H 2 O she was extubated after 36 h of mechanical ventilation but had to be re-intubated because of failing respiratory drive. Following the second intubation she could be successfully weaned off mechanical ventilation after another 72 h. A peripheral arterial catheter needed to be placed for monitoring SaO 2 , since pulse oximetric monitoring yielded invalid SO 2 levels, a fi nding consistent with hemoglobine anomalies as methemoglobinemia or the rare M haemoglobinaemia [ 11 ] . At 24 h of age, unconjugated bilirubine was 5.7 mg/dl and constantly rose to 21 mg/dl by 5 days of age.…”