Site search
Correspondence address
310 Mira Street, Stavropol, Russia, 355017
Tel
+7 865 2352511, +7 865 2353229.
E-mail
medvestnik@stgmu.ru
The journal is included into The list of leading scientific periodicals.
The journal is included into VINITI database and is registered in Electronic scientific library.
The journal is indexed by SCOPUS, Ulrich's International Periodicals Directory.
[Reviews]
Andrei Budnevskiy; Evgeniy Ovsyannikov; Roman Evgenievich Tokmachev; Elena Sergeevna Drobysheva; Valeria Romanovna Drobysheva; Maria Alekseevna Rogatkina;
In recent decades, there has been an increased interest in the problem of methemoglobinemia (MH) as a condition that initiates and sustains systemic inflammation processes in chronic non-infectious diseases associated with the development of oxidative stress. This review summarizes the available data in the literature regarding the etiology and pathogenesis of MH. It provides a detailed description of the categories of causes, examines the possibilities and limitations of modern laboratory and instrumental diagnostic methods, as well as approaches to treatment.
References:
1. Sergunova V. A., Manchenko E. A., Gudkova O. Ye.Hemoglobin: modification, crystallization, polymerization (review). Obshchaya reanimatologiya. – General Reanimatology. 2016;12(6):49-63. (In Russ.). https://doi.org/10.15360/1813-9779-2016-6-49-63
2. Hickey T. B. M., MacNeil J. A., Hansmeyer C., Pickup M. J. Fatal methemoglobinemia: A case series highlighting a new trend in intentional sodium nitrite or sodium nitrate ingestion as a method of suicide. Forensic Science International. 2021;326:110907. https://doi.org/10.1016/j.forsciint.2021.110907
3. Eliseu A., Palma C., Agudo M., Rodrigues M., Santos F. The serious impact of comorbidities on methemoglobinemia: acase report. Cureus. 2023;15(1):e33923. https://doi.org/10.7759/cureus.33923
4. Desrosiers N. A., Chow B. L. C. Impact of methemoglobin on carboxyhemoglobin saturation measurement in fatal sodium nitrate and sodium nitrite cases. Journal of Anal Toxicology. 2023;47(8):750-752. https://doi.org/10.1093/jat/bkad067
5. Liu X., Spolarics Z. Methemoglobin is a potent activator of endothelial cells by stimulating IL-6 and IL-8 production and E-selectin membrane expression. American Journal of Physiology-Cell Physiology. 2003;285:C1036-C1046. https://doi.org/10.1152/ajpcell.00164.2003
6. Planchais C., Noe R., Gilbert M., Lecerf M., Kaveri S. V. [et al.]. Oxidized hemoglobin triggers polyreactivity and autoreactivity of human IgG via transfer of heme. Communications Biology. 2023;6(1):168. https://doi.org/10.1038/s42003-023-04535-5
7. Chikezie P. C., Ekechukwu C. U. Acute patho-toxicological indicators of methaemoglobinemia. Journal of Acute Disease. 2016;5(3):179-184. https://doi.org/10.1016/j.joad.2016.03.001
8. Ivek I., Knotek T., Ivicic T., Rubinic B., Bajlo P. [et al.]. Methemoglobinemia – a case report and literature review. Acta Сlinica Croatica. 2022;61(Suppl 1):93-98. https://doi.org/10.20471/acc.2022.61.s1.16
9. Kedar P. S., Gupta V., Warang P., Chiddarwar A., Madkaikar M. Novel mutation (R192C) in CYB5R3 gene causing NADH-cytochrome b5 reductase deficiency in eight Indian patients associated with autosomal recessive congenital methemoglobinemia type-I. Hematology. 2018;23(8):567-573. https://doi.org/10.1080/10245332.2018.1444920
10. Al-Abdulmalek A., Al-Sulaiman R., Abu-Tineh M., Yassin M. A. Congenital methemoglobinemia: first confirmed case in the arab population with a novel variant in the CYB5R gene in the State of Qatar: a case report. Journal of Blood Medicine. 2023;14:247-251. https://doi.org/10.2147/JBM.S395865
11. He K. Y., Yu H. P., Zou J., Chen X., Chen L. [et al.]. A novel stoploss mutation CYB5R3 c.906A>G(p.*302Trpext*42) involved in the pathogenesis of hereditary methemoglobinemia. Clinica Chimica Acta. 2025;564:119930. https://doi.org/10.1016/j.cca.2024.119930
12. Ullah A., Shah A. A., Syed F., Mahmood A., Ur Rehman H. [et al.]. Molecular dynamic simulation analysis of a novel missense variant in CYB5R3 gene in patients with methemoglobinemia. Medicina (Kaunas). 2023;59(2):379. https://doi.org/10.3390/medicina59020379
13. Thom C. S., Dickson C. F., Gell D. A., Weiss M. J. Hemoglobin variants: biochemical properties and clinical correlates. Cold Spring Harbor Perspectives in Medicine. 2013;3(3):a011858. https://doi.org/10.1101/cshperspect.a011858
14. Dixit V. A., Blumberger J., Vyas S. K. Methemoglobin formation in mutant hemoglobin α chains: electron transfer parameters and rates. Biophysical Journal. 2021;120(17):3807-3819. https://doi.org/10.1016/j.bpj.2021.07.007
15. Rangan A., Savedra M. E., Dergam-Larson C., Swanson K. C., Szuberski J. [et al.]. Interpreting sulfhemoglobin and methemoglobin in patients with cyanosis: An overview of patients with M-hemoglobin variants. International Journal of Laboratory Hematology. 2021;43(4):837-844. https://doi.org/10.1111/ijlh.13581
16. Dolgopolov I. S., Rykov M. Yu., Ryabtsev A. A., Koltsova S. Yu. Congenital methemoglobinemia and abnormal hemoglobin M variant in a newborn with cyanosis. Rossiyskiy Vestnik Perinatologii I Pediatrii. – Russian Bulletin of Perinatology and Pediatrics. 2023;68(2):81-85. (In Russ.). https://doi.org/10.21508/1027-4065-2023-68-2-81-85
17. Ri H., Park Y., Jeon Y. Anesthetic experience: congenital methemoglobinemia due to hemoglobin M. Journal of Dental Anesthesia and Pain Medicine. 2021;21(5):471-474. https://doi.org/10.17245/jdapm.2021.21.5.471
18. Burtseva T. E., Ammosova T. N., Protopopova N. N., Yakovleva S. Y., Slobodchikova M. P. Enzymopenic congenital methemoglobinemia in children of the republic of Sakha (Yakutia). Journal of Pediatric Hematology/Oncology. 2017;39(1):42-45. https://doi.org/10.1097/MPH.0000000000000705
19. Iolascon A., Bianchi P., Andolfo I., Russo R., Barcellini W. [et al.]. SWG of red cell and iron of EHA and EuroBloodNet. Recommendations for diagnosis and treatment of methemoglobinemia. American Journal of Hematology. 2021;96(12):1666-1678. https://doi.org/10.1002/ajh.26340
20. Mohammed Muthanikkatt A., Najeebuddin M., Muthu S., Mohanan A., Balassoundaram V. [et al.]. Deadly shades of green: a cautionary tale of an organic biopesticide poisoning. Toxicology Reports. 2024;13:101750. https://doi.org/10.1016/j.toxrep.2024.101750
21. Alanazi M. Q. Drugs may be induced methemoglobinemia. Journal of Hematology & Thromboembolic Diseases. 2017;6:270. https://doi.org/10.4172/2329-8790.1000270
22. Riaz S., Kudaravalli P., Saleem S. A., Heisig D. Methemoglobinemia: a life-threatening complication of topical pharyngeal anesthetics. Cureus. 2020;12(4):e7900. https://doi.org/10.7759/cureus.7900
23. Shibuya M., Hojo T., Hase Y., Kimura Y., Fujisawa T. Methemoglobinemia caused by a low dose of prilocaine during general anesthesia. Journal of Dental Anesthesia and Pain Medicine. 2021;21(4):357-361. https://doi.org/10.17245/jdapm.2021.21.4.357
24. Rehman A., Shehadeh M., Khirfan D., Jones A. Severe acute haemolytic anaemia associated with severe methaemoglobinaemia in a G6PD-deficient man. BMJ Case Reports. 2018;2018:bcr2017223369. https://doi.org/10.1136/bcr-2017-223369
25. Lewis J. S., Jacobs Z. G. Subtle case of dapsoneinduced methaemoglobinaemia. BMJ Case Reports. 2020;13(8):e235403. https://doi.org/10.1136/bcr-2020-235403
26. Pradoo A., Sriapha C., Trakulsrichai S., Tongpoo A., Kheiawsawang M. [et al.]. Clinical characteristics of acalypha indica poisoning. International Journal of General Medicine. 2020;13:539-545. https://doi.org/10.2147/IJGM.S263199
27. David S. R., Sawal N. S., Hamzah M. N. S. B., Rajabalaya R. The blood blues: a review on methemoglobinemia. Journal of Pharmacology and Pharmacotherapeutics. 2018;9(1):1-5. https://doi.org/10.4103/jpp.JPP_79_17
28. Nappe T. M., Pacelli A. M., Katz K. An atypical case of methemoglobinemia due to self-administered benzocaine. Case Reports in Emergency Medicine. 2015;2015:670979. https://doi.org/10.1155/2015/670979
29. Garanin A. A., Dyachkov V. A., Rubanenko A. O., Reprintseva O. A., Duplyakov D. V. Pulse oximetry methods: opportunities and limitations. Rossijskij kardiologicheskij zhurnal. – Russian Journal of Cardiology. 2023;28(3S):5467. (In Russ.). https://doi.org/10.15829/1560-4071-2023-5467
30. Sun Q., Yue J., Liang P. Killer hiding under normal oxygen saturation: a case report about methemoglobinemia. Translational Pediatrics. 2022;11(6):1058-1062. https://doi.org/10.21037/tp-21-588
31. Hiscock R., Kumar D., Simmons S. W. Systematic review and meta-analysis of method comparison studies of Masimo pulse co-oximeters (Radical-7™ or Pronto-7™) and HemoCue® absorption spectrometers (B-Hemoglobin or 201+) with laboratory haemoglobin estimation. Anaesthesia and Intensive Care. 2015;43(3):341-350. https://doi.org/10.1177/0310057X1504300310
32. Koech A., Mwaniki I., Mutunga J., Mukhanya M., Mwadime E. [et al.]. Diagnostic accuracy of a non-invasive spot-check hemoglobin meter, Masimo Rad-67® pulse CO-Oximeter®, in detection of anemia in antenatal care settings in Kenya. Frontiers in Global Womens Health. 2024;5:1427261. https://doi.org/10.3389/fgwh.2024.1427261
33. Russo R., Marra R., Rosato B. E., Iolascon A., Andolfo I. Genetics and Genomics Approaches for Diagnosis and Research Into Hereditary Anemias. Frontiers in Physiology. 2020;11:613559. https://doi.org/10.3389/fphys.2020.613559
34. Bianchi P., Vercellati C., Fermo E. How will next generation sequencing (NGS) improve the diagnosis of congenital hemolytic anemia? Annals of Translational Medicine. 2020;8(6):268. https://doi.org/10.21037/atm.2020.02.151
35. Cefalu J. N., Joshi T. V., Spalitta M. J., Kadi C. J., Diaz J. H. [et al.]. Methemoglobinemia in the operating room and intensive care unit: early recognition, pathophysiology, and management. Advances in Therapy. 2020;37(5):1714-1723. https://doi.org/10.1007/s12325-020-01282-5
36. Emadi E., Alamdari D. H., Sahebkar A. The potential of leucomethylene blue in methemoglobinemia treatment: a new hope for patients with G6PD? Current Medicinal Chemistry. 2025;32(6):1033-1039. https://doi.org/10.2174/0929867331666230911113159
37. Keats K. R., Robinson R., Patel M., Wallace A., Albrecht S. Ascorbic acid for methemoglobinemia treatment: a case report and literature review. Journal of Pharmacy Practice. 2024;37(4):1015-1020. https://doi.org/10.1177/08971900231188834
38. Usryugov A. Yu., Kazanets E. G., Zakharova G. S., Plyasunova S. A., Sadelov I. O. Methemoglobinemias in children (Review of literature and a clinical case report of a child with hemoglobin M Saskatoon). Voprosy gematologii/onkologii I immunopatologii v pediatrii. – Pediatric Haematology/Oncology and Immunopathology. 2015;14(4):32-36. (In Russ.). https://doi.org/10.24287/1726-1708-2015-14-4-32-36
39. Cho Y., Park S. W., Han S. K., Kim H. B., Yeom S. R. A case of methemoglobinemia successfully treated with hyperbaric oxygenation monotherapy. American Journal of Emergency Medicine. 2017;53(5):685-687. https://doi.org/10.1016/j.jemermed.2017.04.036
40. Espindola K. M. M., Varela E. L. P., de Albuquerque R. F. V., Figueiredo R. A., Dos Santos S. M. [et al.]. Alpha-lipoicacid and its enantiomers prevent methemoglobin formation and DNA damage induced by dapsone hydroxylamine: molecular mechanism and antioxidant action. International Journal Molecular Sciences. 2022;24(1):57.https://doi.org/10.3390/ijms24010057
Keywords: methemoglobin, methemoglobinemia, shortness of breath, cyanosis, pulse oximetry