J Korean Pediatr Soc.  1994 Mar;37(3):416-421.

Transient Methemoglobinemia with Acidosis in Newborn

• Kim HM

Abstract

Methemoglobinemia is an uncommon clinical problem generally caused by inherited disorders of hemoglobin metabolism or environmental toxicity from oxidizing agents. Since methemoglobin has no oxigen carrying capacity, patient with severe methemoglobinemia may have dangerous hypoxia even when arterial oxygen tension is normal. Degree of exposure to oxidants which are benign for older individuals may produce severe methemoglobinemia I Fetal hemoglobin has increased susceptibility to oxidatin. NADH diaphorase activity is reduced to 60% of adult levels in newborn erythrocytes. Low pH further reduces the activity of the enzyme. We report our experience with 5 unrelated nweborns, ranging in age from 9 to 33 days, who presented with diarrhea, dehydration, acidosis and transient methemoglobinemia. No history of toxin exposure could be elicited. On admission, all patients weighted less than their birth weights. All were mild to severely dehydrated, acidotic and methemoglobin levels ranged from 14.7% to 49.1%. In one cases Pseudomonas aeruginosa was isolated in the stool. Rehydration and correction of acidosis were done. Three of them were trated with 2mg/kg of methylene blue and improved immediately. Two patient improved without methylene blue injection. Methemoglobinemia under acidosis may be a common phenomenon in newborn period.

MeSH Terms

Acidosis*
Adult
Anoxia
Birth Weight
Natural Resources
Dehydration
Diarrhea
Dihydrolipoamide Dehydrogenase
Erythrocytes
Fetal Hemoglobin
Fluid Therapy
Humans
Hydrogen-Ion Concentration
Infant, Newborn*
Metabolism
Methemoglobin
Methemoglobinemia*
Methylene Blue
Oxidants
Oxygen
Pseudomonas aeruginosa
Dihydrolipoamide Dehydrogenase
Fetal Hemoglobin
Methemoglobin
Methylene Blue
Oxidants
Oxygen