Department of Pediatrics, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal.
Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal.
JNMA J Nepal Med Assoc. 2022 Oct 1;60(254):906-908. doi: 10.31729/jnma.7874.
Methemoglobinemia is a rare condition characterised by hypoxic state manifesting as headache, nausea, fatigue, and confusion. We report a 2-year-old boy presenting with fever and cough for 7 days with an episode of hypoxia as the saturation declined and did not improve on face mask oxygenation. On further evaluation, acute intravascular hemolysis was established following decreased haemoglobin level, increased levels of lactate dehydrogenase, and unconjugated bilirubin in the setting of documented infection. Assessment of arterial blood gas showed a significantly raised saturation gap and detection of methemoglobin confirmed the diagnosis. He was managed conservatively with packed red blood cells transfusion following which hypoxia was corrected. Methemoglobinemia as a result of hemolysis can be a non-cardio-respiratory cause of hypoxia and inciting aetiology needs to be addressed.
case reports; hemolysis; hypoxia; infection; methemoglobinemia.
高铁血红蛋白血症是一种罕见的疾病，表现为低血氧状态，伴有头痛、恶心、疲劳和意识混乱。我们报告了一例 2 岁男孩，发热咳嗽 7 天，出现缺氧发作，饱和度下降，面罩给氧后无改善。进一步评估发现，血红蛋白水平下降、乳酸脱氢酶水平升高和未结合胆红素升高，确诊为急性血管内溶血。动脉血气分析显示饱和度差异显著升高，检测高铁血红蛋白血症证实了诊断。他接受了红细胞悬液输注的保守治疗，随后缺氧得到纠正。由于溶血引起的高铁血红蛋白血症可能是非心肺原因导致的缺氧，需要明确病因。
病例报告；溶血；缺氧；感染；高铁血红蛋白血症。
