What does affect methemoglobine level in patients with intravascular haemolysis?

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Fatma Abdel Wahab

Hi Marta

Intra vascular hemolysis results in free hemoglobin in circulation

That ferrous iron got oxidized to ferric form by action of plamsa oxidizing proteins

Emmanuel Ifeanyi Obeagu

Hi, what might cause the increase in methaemoglobin in patients with intravascular haemolysis may be that the haptoglobin and albumin systems were overwhelmed.

Gayle Haider

Is the patient on dialysis? it possible that the patient has glucose-6-phosphate dehydrogenase deficiency? The presence of highly oxidative substances has been shown to overwhelm both the Phosphogluconate pathway and the Methemoglobin reductase pathway. There are several papers on this subject:

Indian J Hematol Blood Transfus. 2014 Sep; 30(Suppl 1): 317–319.

Published online 2014 Apr 11. doi: 10.1007/s12288-014-0381-5

INTRAVASCULAR HEMOLYSIS AND METHEMOGLOBINEMIA DUE TO THE OXIDATIVE STRESS OF HIGH-DOSE VITAMINS

Nelson, Ryan; Latifi, Niloofar; Ma, Janet; Beri, Neil; Sell, Rebecca

Critical Care Medicine: December 2016 - Volume 44 - Issue 12 - p 503doi: 10.1097/01.ccm.0000510383.89438.44

Unexpected Intravascular Hemolysis and Methemoglobinemia during Treatment for Lymphoma

James O. Ballard1,📷, Edward J. Wyluda1, Hong Zheng1, Michael H. Creer1American Journal of Medical Case ReportsVol. 4, No. 4, 2016, pp 144-147. doi: 10.12691/ajmcr-4-4-9 |

Marta Załęska-Kocięcka

Thank you all!!! for your replies. Fatma Abdel Wahab but I do not see it so often in heamolysis on MCS at least not up to 10% as in this case. Gayle Haider Interesting point with glucose-6-phosphate dehydrogenase deficiency.And yes the pt was on CVVHD, how does it relate to the deficiency?