Methemoglobinemia is a blood disorder caused by excess methemoglobin. This disease is characterized by a bluish-looking skin color, especially around the lips and fingers.
Methemoglobin is a form of hemoglobin that can carry oxygen, but cannot deliver it to body cells. Methemoglobin levels in the blood are considered normal if they range from 0-3%.
In general, patients with methemoglobinemia have methemoglobin levels of more than 3%. If the methemoglobin level is excessive, the oxygen delivery process will be disrupted, as a result the body's cells will experience a lack of oxygen.
Symptoms of Methemoglobinemia
Symptoms of methemoglobinemia vary widely, depending on the type and cause. However, methemoglobinemia is generally characterized by cyanosis or bluish discoloration of the skin, especially in the areas of the lips and fingers.
In addition, other symptoms that may arise due to a lack of oxygen in the body are:
- Dizzy
- Nauseous
- Headache
- Fatigue
- Hard to breathe
- Seizures
When to go to the doctor
Check with your doctor if you experience the above symptoms or have a parent who suffers from methemoglobinemia. This is because methemoglobinemia can be passed from parents to children.
If you have a family history of methemoglobinemia and are planning to get married, do genetic counseling to find out how likely it is that methemoglobinemia will be passed down in your child.
Reason Methemoglobinemia
The causes of methemoglobinemia vary, depending on the type. Here's the explanation:
Methemoglobinemiainherited (congenital)
Congenital methemoglobinemia is inherited from both parents who have the gene that carries this disease.
Congenital methemoglobinemia is divided into:
- Type 1, occurs when red blood cells lack the enzyme cytochrome b5 reductase.
- Type 2, occurs when the enzyme cytochrome b5 reductase does not function normally.
In addition to these two types, there is also a so-called hemoglobin M . disease. This type of methemoglobinemia results from a genetic abnormality in the hemoglobin protein. A person can develop hemoglobin M disease if one of his parents suffers from this disease.
Methemoglobinemiaobtained
Acquired methemoglobinemia is caused by a side effect of drugs or exposure to certain chemicals. Some of these drugs and chemical compounds are:
- Benzocaine
- Lidocaine
- Metoclopramide
- Nitroglycerin
- Phenytoin
- Sulfonamides
- Antimalarial
- Herbicide
- Insecticide
- Nitrate
- Nitrobenzene
- Sodium chlorite
- Ammonium carbonate or ammonium nitrate
Methemoglobinemia diagnosis
To diagnose methemoglobinemia, the doctor will ask questions about the complaints experienced. In newborns, complaints are usually in the form of bluish skin. Next, the doctor will perform a physical examination.
To confirm the diagnosis, the doctor will perform several supporting examinations, such as:
- Inspectionpoximetry ulcer, to see the saturation or oxygen levels in the body in general.
- Laboratory examination, which includes a complete blood count, blood color examination, liver and kidney function, and blood gas analysis.
Methemoglobinemia Treatment
Treatment for patients with methemoglobinemia varies, depending on the type. In people with hemoglobin M disease, treatment is usually not needed because there are no symptoms.
To treat moderately severe methemoglobinemia, treatments that can be done include:
- Givingmethylene blue or methylene blue.
- Administration of aspirin and ascorbic acid.
- Hyperbaric oxygen therapy.
- Blood transfusion.
- Exchange transfusion.
It is important to note that methylene blue should not be given to methemoglobinemia patients who have or are at risk of developing G6PD disease.
In acquired methemoglobinemia, patients need to avoid drugs and chemical compounds that cause it.
Methemoglobinemia Prevention
Congenital or inherited methemoglobinemia cannot be prevented because it is caused by genetic factors. If you or your partner has methemoglobinemia, seek genetic counseling when planning to have children.
For acquired methemoglobinemia, prevention can be done with a number of the following:
- As much as possible avoid the consumption of materials or chemical compounds that can cause methemoglobinemia. Always do regular checkups if you are required to take certain drugs.
- If you use well water for drinking, close the well hole tightly to prevent it from being contaminated with harmful chemical compounds.
Complications of Methemoglobinemia
In severe cases, methemoglobinemia can be life threatening. High levels of methemoglobinemia in the blood can cause damage to body cells due to lack of oxygen. As a result, the following complications can occur:
- Seizures
- Heart attack
- Coma
- Death
