PDF(Pubmed)
Abstract：
Methemoglobinemia is a condition characterized by the presence of abnormal hemoglobin, known as methemoglobin, in the blood, which impairs the ability of red blood cells to carry oxygen effectively. Symptoms include cyanosis, shortness of breath, fatigue, and in severe cases, organ damage or death. We presented a case of a 49-year-old female with multiple myeloma who developed drug-induced methemoglobinemia while on dapsone prophylaxis for Pneumocystis carinii pneumonia (PCP). Despite normal glucose-6-phosphate dehydrogenase (G6PD) levels, the patient exhibited cyanosis and shortness of breath. The case underscores the importance of considering methemoglobinemia in patients with unexplained hypoxemia, especially when associated with medication use. Diagnosis relies on clinical assessment, arterial or venous blood gas analysis with co-oximetry, and a thorough medication history. Methemoglobinemia poses a diagnostic challenge due to its varied presentations and requires a high index of suspicion, particularly in patients with multiple myeloma receiving potentially causative medications such as dapsone. Thorough evaluation, interdisciplinary collaboration, and prompt treatment are essential for favorable outcomes in these complex cases.
摘要：
高铁血红蛋白血症是一种以血红蛋白异常为特征的疾病，被称为高铁血红蛋白，在血液中，这削弱了红细胞有效携带氧气的能力。症状包括紫癜，呼吸急促,疲劳,在严重的情况下，器官损伤或死亡。我们介绍了一例49岁的多发性骨髓瘤女性，该女性在接受氨苯砜预防卡氏肺囊虫肺炎（PCP）的同时发生了药物诱发的高铁血红蛋白血症。尽管葡萄糖-6-磷酸脱氢酶（G6PD）水平正常，患者表现为紫癜和呼吸急促。该病例强调了在无法解释的低氧血症患者中考虑高铁血红蛋白血症的重要性，特别是当与药物使用相关时。诊断依赖于临床评估，动脉或静脉血气分析与共同血氧饱和度，和彻底的用药史。高铁血红蛋白血症由于其表现多样，对诊断提出了挑战，需要高度怀疑。特别是在接受氨苯砜等潜在致病药物治疗的多发性骨髓瘤患者中。彻底评估，跨学科合作,在这些复杂的病例中，及时的治疗对于取得有利的结果至关重要。
