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The diagnosis is often suspected based on symptoms and a low blood oxygen that does not improve with oxygen therapy. [3] Diagnosis is confirmed by a blood gas. [3] Treatment is generally with oxygen therapy and methylene blue. [3] Other treatments may include vitamin C, exchange transfusion, and hyperbaric oxygen therapy. [3]
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.
The formation of methylene blue after the reaction of hydrogen sulfide with dimethyl-p-phenylenediamine and iron(III) at pH 0.4 – 0.7 is used to determine by photometric measurements sulfide concentration in the range 0.020 to 1.50 mg/L (20 ppb to 1.5 ppm). [62]
The most widely employed photosensitizer in clinical practice is the phenothiazine derivative, methylene blue, which carries a +1 charge. [27] Methylene blue is also favored due to its long record of safe use in patients, both in surgical staining and the systemic treatment of methemoglobinemia. [28]
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.
In patients with significant respiratory distress, supplemental oxygen (in the form of nasal canula or continuous positive airway pressure depending on severity) should be given immediately. [10] [11] If the methemoglobin levels are positive for methemoglobinemia, first-line treatment is to administer methylene blue. [1]
The first-line treatment for severe methemoglobinemia is methylene blue, a medication that will reduce methemoglobin in the blood. This is possible because methylene blue oxidizes NADPH, which in turn can convert methemoglobin back to hemoglobin. [33]
NADPH deficiency can cause a dysfunction in glutathione peroxidase which is an enzyme that converts hydrogen peroxide (a reactive oxygen species) into water. G6PD (glucose-6-phosphate dehydrogenase) deficiency exacerbated by administration of oxidant drugs (e.g., primaquine, dapsone, quinidine) can also result in Heinz bodies. G6PD deficient ...
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