Thinking outside of the blue box: a case presentation of neonatal methemoglobinemia

Vijver, M. Van de; Parish, Emma; Aladangady, Narendra

doi:10.1038/jp.2013.74

Cited by 5 publications

(6 citation statements)

References 9 publications

(7 reference statements)

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“…[2] The NADPH diaphorase II system is pharmacologically active and constitutes the basis of methylene blue treatment. [3,4] Exposure to oxidizing agents causes 100 to 1000 times more metHb formation than normal. Infants less than 3 months of age are particularly prone to acquired methemoglobinemia.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the cytochrome b5 metHb reductase activity and concentration are low before 6 months of age. [4,5] Other factors include the higher gastric pH in infants and the higher proliferation of nitrate to nitrite-converting bacteria in the gut. The presence of nitrite facilitates the conversion of hemoglobin to metHb.…”

Section: Discussionmentioning

confidence: 99%

“…[6] Treatment with 1-2 mg/kg methylene blue for 5 minutes is usually recommended in patients with a metHb blood level of >20% if symptomatic, and >30% in asymptomatic patients. [3,4] However, methylene blue is always available in our country for emergency treatment. In addition, methylene blue does not have an effect on the clinic in G6PDdeficient patients and it can trigger hemolysis as a source of oxidant stress.…”

Section: Discussionmentioning

confidence: 99%

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Methemoglobinemia After Local Prilocain During Neonatal Circumcision And Treatment With Ascorbic Asit

Haykır¹

2018

South Clin Ist Euras

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Methemoglobinemia occurs when the hemoglobin molecule is oxidized from the normal ferrous state to the ferric state. Rarely, it may be a congenital condition (methemoglobin-reductase deficiency), but more frequently it is a result of oxidant exposure. Among the large number of agents that can cause acquired methemoglobinemia is prilocaine, commonly used for local anesthesia during circumcision. Methylene blue is known to be the best treatment option; however it is not always available, and there is no universally accepted alternative. Vitamin C has been reported as an alternative treatment in recent years, but there is no definitive information about efficacy, dose, and renal side effects at high doses. Presently described is the case of an infant who developed cyanosis after a local application of prilocaine during circumcision who was successfully treated with the intravenous administration of vitamin C.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Methemoglobinemia After Local Prilocain During Neonatal Circumcision And Treatment With Ascorbic Asit

Haykır¹

2018

South Clin Ist Euras

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“…Her ne kadar prilokain çoğunlukla suçlanmış ve methemoglobinemi için güvenilir bir ilaç olarak bupivakain gösterilmişse de van de Vijver ve arkadaşları bupivakainle yapılan spinal anestezi sonrası sezaryen ile doğum yapan bir annenin term bebeğinde methemoglobinemi geliştiğini bildirmişlerdir (6,7).…”

Section: Discussionunclassified

Üç günlük yenidoğanda methemoglobinemi; olgu sunumu

Korkmaz¹,

Korkut²,

Baştuğ³

et al. 2017

Bakirkoy

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Methemoglobinemia in a 3 days old new born: case reportLocal anesthesia with prilocaine is a frequent practice in our country to prevent the pain during circumcision. Prilocaine, in turn, has been demonstrated to potentially cause methemoglobinemia in young babies and newborns. Herein we have presented a case of methemoglobinemia in a three-days-old male newborn hospitalized upon the detection of cyanosis and hypoactivity at the physical examination during follow up period immediately after circumcision under anesthesia with prilocaine. At presentation, the patient had no other sign than those of cyanosis and hypoactivity. Blood methemoglobin level was found to be %32.4, and complete recovery was achieved with treatment. Fetal hemoglobin is more susceptible to ferric state, and the systems to help the prevention of methemoglobinemia are insufficient in early periods of life. For these reasons, it has been discussed here that in young children other anesthetic agents than prilocaine should be used. In this case the search related with this subject has also been discussed in the light of literature knowledge and experience.

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“…Acquired methemoglobinemia is due to increased methemoglobin formation by exogenously administered agents such as benzocaine and nitrate solutions [2,3]. The drugs usually implicated in causing methemoglobinemia have a free nitrate group which can oxidize the ferrous moiety in hemoglobin to the ferric form.…”

mentioning

confidence: 99%

Neonatal Acquired Methemoglobinemia – Can Broad Spectrum Antibiotics be Implicated?

Andrade

Lewis

et al. 2019

Indian J Pediatr

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Thinking outside of the blue box: a case presentation of neonatal methemoglobinemia

Abstract: We report the case of a full-term neonate who presented with cyanosis from birth secondary to methemoglobinemia precipitated by the obstetric use of bupivacaine in a spinal anaesthetic for caesarean delivery.

Cited by 5 publications

References 9 publications

Methemoglobinemia After Local Prilocain During Neonatal Circumcision And Treatment With Ascorbic Asit

Methemoglobinemia After Local Prilocain During Neonatal Circumcision And Treatment With Ascorbic Asit

Üç günlük yenidoğanda methemoglobinemi; olgu sunumu

Neonatal Acquired Methemoglobinemia – Can Broad Spectrum Antibiotics be Implicated?

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