30 patients with anemia due to bone marrow depression and 60 healthy people (control) ages of 17-50 were monitored the rate of MetHb, number of erythrocyte and amount of Hb. The results have showns that percentage of MetHb in the control was the same as other studies. The average number of erythrocyte in patients with anemia was 1,85 +/- 0,5 million/lit, significant lower than this of control. The percentage of MetHb in patients with anemia due to the bone marrow depression much higher than normal level. The disease occurred mainly in young men and its progress also was more servere.
Anemia ; Bone marrow ; Methemoglobin

The hyper-methemoglobinemia causes the oxygen transfer disorder. The clinical symptoms depends on the level of methemoylobinemia. Hypermethemoglobinemia can be congenital or acquired hypermethemoglobinemia. The congenital hypermethemoglobinemia caused by partial or total methemoglobine reeducates deficiency in patients with rare genetic heterozygous enzyme deficiency due to the abnormal hemoglobin. The acquired hypermethemoglobinemia occurred after exposure to colour compound, food and drinking water with nitrate or drugs. The determination of causative agent of hypermethemoglobin help treating more effectively
Methemoglobin ; Hemoglobins, Abnormal ; Therapeutics ; Methemoglobinemia

The changes of methemoglobin concentration in the blood after the use of lidocatine or Marcaine were investigated in the human and the rabbits. In the human the drugs were give by the epidural route and intramuscularly in rabbits. Lidocaine did not increase the methemoglobin concentration in humans but marcaine increased the methemoglobin concentration in the blood.
Bupivacaine* ; Humans ; Lidocaine ; Methemoglobin* ; Rabbits

BACKGROUND: We evaluated the performance of the GEM Premier 4000 (Instrumentation Laboratory, USA), a new blood gas/electrolytes/co-oximetry analyzer, according to the Clinical and Laboratory Standard Institute (CLSI) guidelines. METHODS: Within-run precision, total-run precision, linearity and sample-related carryover were analyzed using quality control materials at three different concentration levels for each analytes. Correlation was compared with the routinely used NOVA CCX2 (Nova Biomedical, USA) with patients' whole blood samples. RESULTS: The within-run and the total-run precisions of the GEM Premier 4000 showed very low CV of 0.04~4.40% and 0.06~4.11%, respectively, in all parameters except the lactate, which had CV of 5.58% in Level 1 QC material. The system showed a good linearity (r2=0.997~1.000, systemic error=0.00~0.20%) for all items. Sample-related carryover was -4.35%~0.15%. In comparison with the NOVA CCX2 instrument, correlation was high in all parameters with the r value ranging from 0.983-0.999 except for carboxyhemoglobin (r=0.804) and methemoglobin (r=0.010) whose concentrations were in the lower level. CONCLUSIONS: GEM Premier 4000 showed good analytical performance required for blood gas analyzer in its precision, linearity, sample-related carryover, and close correlation with NOVA CCX2. It fulfills most of the requirements for both point-of-care and laboratory use.
Carboxyhemoglobin ; Lactic Acid ; Methemoglobin ; Quality Control

BACKGROUND: To determine whether N-acetylcysteine(NAC) reduces methemoglobin. METHOD: We carried out an in vivo experiment in rats, weighed about 300g. Each rat was ingested 200mg of dapsone(4,4'diaminodiphenyl sulphone) to induce methemo- globinemia. After 1 hour, 30 rats were received NAC 160mg(2ml) and another 30 rats, served as control, were received 2ml of normal saline orally,4 times hourly. Serum methemoglobin concentrations were checked 1,6, and 24 hours after dapsone ingestion. RESULT: The methemoglobin concentrations on each time were 27.1+/-5.8%,23.5+/-8.8%, 17.1+/-6.4%(mean+/-SD) in control group and 25.5+/-6.3%, 25.5+/-8.8%, 65.5+/-31.2%(mean+/-SD) in NAC group. There were no differences on methemoglobin concentrations at 1 and 6 hours between two groups(P>.05). At 24 hours, the methemoglobin concentrations of NAC group was significantly higher than those of control group(P<.01). CONCLUSION: NAC had no therapeutic effects on dapsone induced methemoglobinemia in this experimental setting.
Acetylcysteine* ; Animals ; Dapsone ; Eating ; Methemoglobin ; Methemoglobinemia* ; Rats

Primaquine is often administered for the hypnozoite stage of Plasmodium vivax and Plasmodium ovale. Primaquine (with clindamycin) is also an alternative drug for treatment of pneumocystis pneumonia when trimethoprim/sulfamethoxazole cannot be used. Primaquine may cause methemoglobinemia, an altered state of hemoglobin in which the ferrous state of heme is oxidized to the ferric state. We report a case of methemoglobinemia caused by a standard dose of primaquine plus clindamycin in a 27-year-old female recipient of a kidney transplant who was diagnosed with pneumocystis pneumonia.
Adult ; Clindamycin ; Female ; Heme ; Humans ; Kidney ; Methemoglobin ; Methemoglobinemia* ; Plasmodium ovale ; Plasmodium vivax ; Pneumonia, Pneumocystis ; Primaquine*

Methemoglobinemia results from the oxidation of ferrous iron (Fe++) to ferric iron (Fe+++) within hemoglobin. It is caused by various etiologies, including the herbicide Propanil. Patients with low levels of methemoglobin (metHb) are asymptomatic but symptomatic patients and patients with high levels of metHb require treatment. Methylene blue is the first choice for the treatment of methemoblobinemia, but has some complications such as hemolytic anemia and rebound methemoglobinemia. We report the case of a 91-year-old woman who died of aniline herbicides poisoning. The level of metHb in her blood was initially 20.7% and her mental status was drowsy. She was intravenously treated with methylene blue within a therapeutic range for methemoglobinemia. After treatment with methylene blue, the level of metHb decreased but later increased above 20%. Methylene blue treatment was repeatedly attempted, but the patient suffered from hemolytic anemia and rebound methemoglobinemia. The patient finally died from renal failure and cardiopulmonary collapse. We must be careful because methemoglobinemia can occur even when treated pesticides such as propranil.
Anemia, Hemolytic ; Female ; Herbicides ; Humans ; Iron ; Methemoglobin ; Methemoglobinemia* ; Methylene Blue ; Pesticides ; Poisoning ; Propanil* ; Renal Insufficiency

PURPOSE: Drining of Nitrate-contaminated water has been the most common cause of acquired methemoglobinemia. We had cyanotic infant diagnosed as methemoglobinemia caused by feeding with powdered formula mixed with nitrate-contaminated ground water. METHODS: We had done epidemiologic investigation to identify the cause of an infant's methemoglobinemia. Analysis of ground water and blood test of involved family members and neighbors were performed RESULTS: Analysis of the 8 household ground water revealed high level of nitrate(29837 ppm), indicating contamination of water as the cause of methemoglobinemia. We had done blood tests to evaluate the methemoglobin level of 65 people in the neighborhood ; among them, there was no infant and we could not find another cyanotic case of methemoglobinemia. They had normal blood level of methemoglobinemic concentration. CONCLUSIONS: If ground water will be used for drinking water, especially for formula water, epidemiologic investigation and analysis of ground waters should be recommended.
Drinking Water ; Family Characteristics ; Groundwater* ; Hematologic Tests ; Humans ; Infant ; Methemoglobin ; Methemoglobinemia* ; Residence Characteristics

Acute propanil pesticide poisoning is rare and propanil is known to have a low toxicity. Propanil metabolite induces the conversion of Fe2+ in hemoglobin to Fe3+, forming methemoglobin. Patients with low metHb levels are asymptomatic, but severe methemoglobinemia produces headache, dizziness, decreased consciousness, convulsion, and death. Thus, delayed diagnosis in patients with severe methemoglobinemia can be lethal. We describe the case of a 60-year-old man who died of acute propanil pesticide poisoning. He presented with severe methemoglobinemia. Early methylene blue therapy is recommended for propanil pesticide poisoning patients with symptoms and signs of methemoglobinemia.
Consciousness ; Delayed Diagnosis ; Dizziness ; Headache ; Humans ; Methemoglobin ; Methemoglobinemia* ; Methylene Blue ; Middle Aged ; Poisoning* ; Propanil* ; Seizures

OBJECTIVE: To report two cases of methemoglobinemia induced by inhaled nitrobenzene and dermally absorbed aniline. METHODS: We have evaluated a 37-year-old male worker exposed to nitrobenzene by inhalation while conducting maintenance job of mononitrobenzene pump and a 25-year-old male worker exposed dermally to aniline while unloading. RESULTS: The first case is a 37-year-old male exposed to nitrobenzene. His blood methemoglobin concentration level was initially 19.8%, and chest X-ray was normal. After oxygen therapy, the blood methemoglobin concentration level decreased to 2.1%, and the symptoms were alleviated. The second case is a 25-year-old male exposed dermally to aniline. His chest X-ray was normal, but blood methemoglobin concentration level reached maximally 46.8%. He was treated with methylene blue due to relatively high blood methemoglobin level. Gradually after the treatment, his methemoglobin concentration level was normalized to 0.8% and simultaneously symptoms were resolved. CONCLUSIONS: After the thorough exposure investigations and medical evaluations, we have concluded that these cases were methemoglobinemia induced by occupational exposure to nitrobenzene and aniline. We suggest that businesses which handle methemoglobinemia-causing substances control the engineering process strictly, implement periodic screening, and establish emergency patient management system.
Adult ; Commerce ; Emergencies ; Humans ; Inhalation ; Male ; Mass Screening ; Methemoglobin ; Methemoglobinemia* ; Methylene Blue ; Occupational Exposure ; Oxygen ; Thorax