Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, South Paris University Hospitals, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France,
Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, South Paris University Hospitals, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.
Neonatology. 2019;116(3):295-298. doi: 10.1159/000501462. Epub 2019 Aug 27.
We report the first case of life-threatening extreme neonatal-acquired methemoglobinemia that occurred during inhaled nitric oxide (iNO) at the standard 20 ppm dose in a neonate with early onset sepsis and suprasystemic pulmonary hypertension. Life-threatening methemoglobinemia has been efficaciously treated with methylene blue and ascorbic acid, while stopping iNO and starting iloprost and sildenafil. The patient was subjected to various tests (including gene sequencing and hemoglobin electrophoresis) and did not have any known genetic cause or predisposition for methemoglobinemia. Neuroimaging and the 2-year clinical follow-up were completely normal.
我们报告了首例在接受标准 20ppm 吸入一氧化氮（iNO）治疗的早发性败血症和超系统性肺动脉高压新生儿中发生的危及生命的极端新生儿获得性高铁血红蛋白血症。使用亚甲蓝和抗坏血酸治疗危及生命的高铁血红蛋白血症是有效的，同时停止 iNO 并开始使用伊洛前列素和西地那非。该患者接受了各种检查（包括基因测序和血红蛋白电泳），并且没有任何已知的高铁血红蛋白血症遗传原因或易感性。神经影像学和 2 年的临床随访完全正常。
