Primaquine-induced methemoglobinemia in a child treated for malaria
Abstract
Methemoglobinemia results from an increased concentration of methemoglobin in the blood, impairing oxygen delivery to tissues. It is considered a rare condition that requires a high diagnostic suspicion.
We report the case of a pediatric patient with malaria who presented with cyanosis and hypoxemia as manifestations of methemoglobinemia induced by primaquine treatment.
The patient responded adequately after antimalarial drug suspension and ascorbic acid administration.
Downloads
References
1. Eberle SE, Chaves A, Pepe C, Diuzeide MP, Fernández D, Novello F, et al. Metahemoglobinemia recesiva congénita. A propósito de un caso. Hematología. 2022;26:97-100. https://doi.org/10.48057/hematologa.v26i2.427
2. Lolascon A, Bianchi P, Andolfo I, Russo R, Barcellini W, Fermo E, et al. Recommendations for diagnosis and treatment of methemoglobinemia. Am J Hematol. 2021;96:1666-78. https://doi.org/10.1002/ajh.26340
3. Darling RC, Roughton FJW. The effect of methemoglobin on the equilibrium between oxygen and hemoglobin. Am J Physiol. 1942;137:56-68. https://doi.org/10.1152/ajplegacy.1942.137.1.56
4. Prchal JT. Methemoglobinemia and other dyshemoglobinemias. En: Kaushansky K, Prchal JT, Burns LJ, Lichtman MA, Levi M, Linch DC, editors. Williams Hematology. 10th edition. New York: McGraw-Hill Education; 2021. p. 859.
5. Dekker J, Eppink MH, van Zwieten R, de Rijk T, Remacha AF, Law LK, et al. Seven new mutations in the nicotinamide adenine dinucleotide reduced-cytochrome b5 reductase gene leading to methemoglobinemia type I. Blood. 2001;97:1106-14. https://doi.org/10.1182/blood.v97.4.1106
6. Jenkins MM, Prchal JT. A novel mutation found in the 3’ domain of NADH-cytochrome B5 reductase in an African-American family with type I congenital methemoglobinemia. Blood. 1996;87:2993-9.
7. Rubens J, Jiménez ME, Francisco EN. Cianosis como manifestación de metahemoglobinemia. Rev Med Inst Mex Seguro Soc. 2008;46:439-44.
8. Kane GC, Hoehn SM, Behrenbeck TR, Mulvagh SL. Benzocaine-induced methemoglobinemia based on the Mayo Clinic experience from 28,478 transesophageal echocardiograms: Incidence, outcomes, and predisposing factors. Arch Intern Med. 2007;167:1977-82. https://doi.org/10.1001/archinte.167.18.1977
9. Martínez JM, García JP, Domínguez M. Metahemoglobinemia en lactantes mayores de un año. Med Clin (Barc). 2018;151:278-80. https://doi.org/10.1016/j.medcli.2017.12.009
10. Ivek I, Knotek T, Ivičić T, Rubinić B, Bajlo P, Hamzić J. Methemoglobinemia – A case report and literature review. Acta Clin Croat. 2022;61(Suppl.1):S93-8. https://doi.org/10.20471/acc.2022.61.s1.16
11. Cortazzo JA, Lichtman AD. Methemoglobinemia: A review and recommendations for management. J Cardiothorac Vasc Anesth. 2014;28:1043-7. https://doi.org/10.1053/j.jvca.2013.02.005
12. Ewenczyk C, Leroux A, Roubergue A, Laugel V, Afenjar A, Saudubray JM, et al. Recessive hereditary methaemoglobinaemia, type II: Delineation of the clinical spectrum. Brain. 2008;131:760-1. https://doi.org/10.1093/brain/awm337
13. Skold A, Cosco DL, Klein R. Methemoglobinemia: Pathogenesis, diagnosis, and management. South Med J. 2011;104:757-61. https://doi.org/10.1097/smj.0b013e318232139f
14. Keats KR, Robinson R, Patel M, Wallace A, Albrecht S. Ascorbic acid for methemoglobinemia treatment: A case report and literature review. J Pharm Pract. 2023;37:1015-20. https://doi.org/10.1177/08971900231188834
15. Lee KW, Park SY. High-dose vitamin C as treatment of methemoglobinemia. Am J Emerg Med. 2014;32:936. https://doi.org/10.1016/j.ajem.2014.05.030
16. Cefalu JN, Joshi TV, Spalitta MJ, Kadi CJ, Diaz JH, Eskander JP, et al. Methemoglobinemia in the operating room and intensive care unit: Early recognition, pathophysiology, and management. Adv Ther. 2020;37:1714-23. https://doi.org/10.1007/s12325-020-01282-5
17. Visclosky T, Schaeffer W, Pomeranz E, Ponce DM. Primaquine overdose in a toddler. Am J Emerg Med. 2021;45:676.e3-676.e5. https://doi.org/10.1016/j.ajem.2020.10.084
18. De Crem N, Verleden GM, Godinas L, Vos R. Once in a blue moon: Primaquine-induced methemoglobinemia - A case report. Respir Med Case Rep. 2022;38:101675. https://doi.org/10.1016/j.rmcr.2022.101675
19. Jordán C, Palomo M, Pérez M, Poveda JL. Primaquine-induced methemoglobinaemia. Farm Hosp. 2011;35:278-9. https://doi.org/10.1016/j.farma.2010.08.004
20. Carrera F, Pérez P, Cermeño O, Malave L, Rojas M. Metahemoglobinemia adquirida inducida por fármacos antipalúdicos. Med Interna (Caracas). 2016;32:310-2.
Some similar items:
- Ana María Vásquez, Felipe Sanín, Luis Gonzalo Álvarez, Alberto Tobón, Alexandra Ríos, Silvia Blair, Therapeutic efficacy of a regimen of artesunate-mefloquine-primaquine treatment for Plasmodium falciparum malaria and treatment effects on gametocytic development , Biomedica: Vol. 29 No. 2 (2009)
- Jaime Carmona-Fonseca, Gonzalo Álvarez, Silvia Blair, Plasmodium vivax malaria: treatment of primary attacks with primaquine, in three different doses, and a fixed dose of chloroquine, Antioquia, Colombia, 2003-2004 , Biomedica: Vol. 26 No. 3 (2006)
- Iveth J. González, Metacaspases and their role in the life cycle of human protozoan parasites , Biomedica: Vol. 29 No. 3 (2009)
- Rosa Magdalena Uscátegui, Adriana M. Correa, Jaime Carmona-Fonseca, Changes in retinol, hemoglobin and ferritin concentrations in Colombian children with malaria , Biomedica: Vol. 29 No. 2 (2009)
- Alberto Tobón, Danger signs in the malaria patient , Biomedica: Vol. 29 No. 2 (2009)
- Juan Gabriel Piñeros, Margarita Arboleda, Juan Camilo Jaramillo, Silvia Blair, Report of five cases of severe neonatal Plasmodium vivax malaria in Urabá, Colombia , Biomedica: Vol. 28 No. 4 (2008)
- Amanda Maestre, Jaime Carmona-Fonseca, Amanda Maestre, Alta frecuencia de mutaciones puntuales en pfcrt de Plasmodium falciparum y emergencia de nuevos haplotipos mutantes en Colombia , Biomedica: Vol. 28 No. 4 (2008)
- Silvia Blair, Ana Mercedes Rada, Carolina Moreno, Successful in vitro culture of Plasmodium falciparum gametocytes , Biomedica: Vol. 28 No. 4 (2008)
- Jaime Carmona-Fonseca, Eliana Arango, Silvia Blair, Gametocytemia in falciparum malaria treated with amodiaquine or artesunate , Biomedica: Vol. 28 No. 2 (2008)
- Angélica Knudson, Rubén Santiago Nicholls, Ángela Patricia Guerra, Ricardo Sánchez, Clinical profiles of patients with uncomplicated Plasmodum falciparum malaria in northwestern Colombia , Biomedica: Vol. 27 No. 4 (2007)
Copyright (c) 2024 Biomedica
This work is licensed under a Creative Commons Attribution 4.0 International License.
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
