Thiri Thiri, San Su Su, Lwin Zaw Thant
Clinical Neurophysiology, Calderdale Royal Hospital, Halifax, GBR.
General Medicine, King's Mill Hospital, Sutton-in-Ashfield, GBR.
Cureus. 2025 May 5;17(5):e83525. doi: 10.7759/cureus.83525. eCollection 2025 May.
Methaemoglobinaemia is rarely considered as a differential diagnosis in patients presenting with shortness of breath and cyanosis. It can occur due to either congenital or acquired causes. The effect of medication is an important consideration as an acquired cause of methaemoglobinaemia, and if the diagnosis is missed, it may result in a fatal outcome. This scenario highlights the importance of awareness through thorough history-taking and careful review of investigations. Dapsone (4,4'-diaminodiphenyl sulfone) was identified as the main contributing factor in this case, and the symptoms resolved following its immediate discontinuation, with an improvement in oxygen saturation and a reduction in methaemoglobin levels.
高铁血红蛋白血症在出现呼吸急促和发绀的患者中很少被视为鉴别诊断。它可由先天性或后天性原因引起。药物作用作为高铁血红蛋白血症的一个重要后天性病因需重点考虑,若漏诊可能导致致命后果。这种情况凸显了通过全面病史采集和仔细审查检查结果来提高认识的重要性。在该病例中,氨苯砜(4,4'-二氨基二苯砜)被确定为主要促成因素,停用该药后症状立即缓解,血氧饱和度提高,高铁血红蛋白水平降低。