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Classical drug causes of methemoglobinemia include various antibiotics (trimethoprim, sulfonamides, and dapsone [8]), local anesthetics (especially articaine, benzocaine, prilocaine, [9] and lidocaine [10]), and aniline dyes, metoclopramide, rasburicase, umbellulone, chlorates, bromates, and nitrites. [11] Nitrates are suspected to cause ...
The structure of cytochrome b5 reductase, the enzyme that converts methemoglobin to hemoglobin. [1]Methemoglobin (British: methaemoglobin, shortened MetHb) (pronounced "met-hemoglobin") is a hemoglobin in the form of metalloprotein, in which the iron in the heme group is in the Fe 3+ state, not the Fe 2+ of normal hemoglobin.
Methemoglobinemia is also an uncommon cause of drug-induced nonautoimmune hemolytic anemia. In methemoglobinemia, drug-induced oxidative stress causes the oxidation of the Fe 2+ ion within the heme molecule in hemoglobin to Fe 3+, forming excessive amounts of methemoglobin.
Methemoglobinemia is a condition caused by elevated levels of methemoglobin in the blood. Methaemoglobin is a form of Hb that contains the ferric [Fe 3+] form of iron, instead of the ferrous [Fe2 +] form . Methemoglobin cannot bind oxygen, which means it cannot carry oxygen to tissues.
Hemoglobin M disease is a rare form of hemoglobinopathy, characterized by the presence of hemoglobin M (HbM) and elevated methemoglobin (metHb) level in blood. [1] HbM is an altered form of hemoglobin (Hb) due to point mutation occurring in globin-encoding genes, mostly involving tyrosine substitution for proximal (F8) or distal (E7) histidine residues. [2]
A methemoglobin level > 1.5 g/dL causes cyanosis. The most common congenital cause is a deficiency in the enzyme cytochrome b5 reductase which reduces methemoglobin in the blood. [22] However, in infants the most common cause of methemoglobinemia is acquired through the ingestion of nitrates (NO − 3) through well water or foods.
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The most common and successful treatment used to treat patients with high levels of methemoglobinemia is the antidote methylene blue. Methylene blue is already recognized as a product of the reversible reaction fueled by NAPHD methemoglobin reductase, catalyzed by leukcomethylene, to reduce methemoglobin to hemoglobin.