A blue blood toddler- a case report of methemoglobinemia and literature review.

IF 3.1 3区医学 Q1 PEDIATRICS Italian Journal of Pediatrics Pub Date : 2025-02-21 DOI:10.1186/s13052-025-01886-z

Dorina Pjetraj, Madiha El Mechri, Silvia Bacelli, Elisabetta Fabiani, Laura Caponi, Simona Gatti, Elena Lionetti

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Abstract

Background: Methemoglobinemia (MetHb) is a rare and potentially life-threatening condition caused by oxidation of ferrous hemoglobin (Fe2+) to the ferric (Fe3+) state, making it incapable of binding oxygen and resulting in cyanosis and tissue ischemia.

Case presentation: This case presentation describes a 1-year-old boy who developed sudden cyanosis and reduced consciousness disorder. An initial assessment showed decreased oxygen saturation (SpO2 85%) despite oxygen therapy, while point-of-care venous blood gas (VBG) analysis assessed high rates of MetHb (72.7%). Methylene blue and ascorbic acid were administered, resulting in in rapid clinical recovery and normalized VBG test results. The trigger for this condition was not identified, however the most likely cause of poisoning was attributed to food oxidants.

Conclusion: Starting from the description of a clinical case, this paper discusses the causes and mechanisms of possible poisoning and reviews recent guidelines for methemoglobinemia management.

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蓝血幼儿-高铁血红蛋白血症1例报告并文献复习。

背景：高铁血红蛋白血症（MetHb）是一种罕见且可能危及生命的疾病，由铁血红蛋白（Fe2+）氧化为铁（Fe3+）状态，使其无法结合氧气，导致发绀和组织缺血。病例报告：本病例报告描述了一个1岁的男孩，他出现了突然的紫绀和意识障碍。初步评估显示，尽管进行了氧疗，但氧饱和度（SpO2 85%）仍有所下降，而现场静脉血气（VBG）分析评估了甲胺磷的高发生率（72.7%）。给予亚甲蓝和抗坏血酸治疗，临床恢复迅速，VBG检测结果正常。引发这种情况的原因尚未确定，但最可能的中毒原因是食物氧化剂。结论：本文从一个临床病例的描述出发，讨论了可能中毒的原因和机制，并回顾了高铁血红蛋白血症的最新治疗指南。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Italian Journal of Pediatrics PEDIATRICS-

CiteScore

6.10

自引率

13.90%

发文量

192

审稿时长

6-12 weeks

期刊介绍： Italian Journal of Pediatrics is an open access peer-reviewed journal that includes all aspects of pediatric medicine. The journal also covers health service and public health research that addresses primary care issues. The journal provides a high-quality forum for pediatricians and other healthcare professionals to report and discuss up-to-the-minute research and expert reviews in the field of pediatric medicine. The journal will continue to develop the range of articles published to enable this invaluable resource to stay at the forefront of the field. Italian Journal of Pediatrics, which commenced in 1975 as Rivista Italiana di Pediatria, provides a high-quality forum for pediatricians and other healthcare professionals to report and discuss up-to-the-minute research and expert reviews in the field of pediatric medicine. The journal will continue to develop the range of articles published to enable this invaluable resource to stay at the forefront of the field.