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Methemoglobinemia can be due to certain medications, chemicals, or food or it can be inherited. [2] Substances involved may include benzocaine , nitrites , or dapsone . [ 3 ] The underlying mechanism involves some of the iron in hemoglobin being converted from the ferrous [Fe 2+ ] to the ferric [Fe 3+ ] form. [ 3 ]
In human blood a trace amount of methemoglobin is normally produced spontaneously; the enzyme methemoglobin reductase is responsible for converting methemoglobin back to hemoglobin. [23] [24] Methemoglobinemia can be hereditary but more commonly occurs as a side effect of certain medications or by abuse of recreational drugs. [25]
In some cases, a drug can cause the immune system to mistakenly think the body's own red blood cells are dangerous, foreign substances. Antibodies then develop against the red blood cells. The antibodies attach to red blood cells and cause them to break down too early. It is known that more than 150 drugs can cause this type of hemolytic anemia ...
Cetacaine has been known to cause adverse effects in the patients it has been administered to. These include hypersensitivity in the form of anaphylaxis, dermatitis, erythema, pruritus which can lead to oozing and vesiculation. [4] There have also been accounts of rashes, edema, urticarial and other allergic symptoms as well as methemoglobinemia.
This condition can also be caused by or occur with another disorder (secondary) or rarely, occur following the use of certain drugs (such as penicillin) or after a person has a blood and marrow stem cell transplant. [14] Secondary causes of autoimmune hemolytic anemia include: [14] Autoimmune diseases, such as lupus; Chronic lymphocytic leukemia
This is common in immunocompromised, elderly, and diabetic people. High blood loss can also come from the increased loss of blood during menstruation, childbirth, cancers of the intestines, and disorders that hinder the blood's ability to coagulate. [citation needed] Medications can have adverse effects and cause nutritional anemia as well.
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.
Other factors that can cause an excess amount of hemoglobin are: Smoking (which may result in low blood oxygen levels) Higher altitudes where your red blood cell production naturally increases to compensate for the lower oxygen supply there; Specific disorders or other factors that may cause a high hemoglobin count include: Lung disease [3]