Methemoglobinemia with symptoms of acute coronary syndrome

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The authors present treatment of patients with severe secondary methemoglobinemia following drug therapy. This disease manifested itself with symptoms of acute coronary syndrome. Data on etiology, pathogenesis, clinical picture and treatment approaches are presented. The role of some common drugs that can cause acute and chronic methemoglobinemia with significant hemic hypoxia and life-threatening organ disorders especially in patients with initially burdened vascular anamnesis is considered. Diagnosis of methemoglobinemia in some cases can be difficult due to similarity of symptoms with other common syndromes and no proper vigilance among emergency medical workers.

Keywords:

methemoglobinemia

acute coronary syndrome

hemic hypoxia

Authors:

Lebedeva A.Yu.

Moscow Multi-field Clinical Center “Kommunarka”

ORCID: 0000-0002-4060-0786

Kurenkov D.A.

Moscow Multi-field Clinical Center “Kommunarka”

ORCID: 0009-0008-7536-2985

Balan V.M.

Moscow Multi-field Clinical Center “Kommunarka”

ORCID: 0009-0007-9316-7502

Baidaev M.A.

Moscow Multi-field Clinical Center “Kommunarka”

ORCID: 0009-0007-1505-3614

Received:

16.09.2024

Accepted:

06.10.2024

List of references:

Kwok S, Fischer JL, Rogers JD. Benzocaine and lidocaine induced methemoglobinemia after bronchoscopy: a case report. Journal of Medical Case Reports. 2008;2:16. https://doi.org/10.1186/1752-1947-2-16
Gay HC, Amaral AP. Acquired methemoglobinemia associated with topical lidocaine administration: a case report. Drug Safety — Case Reports. 2018;5(1):15. https://doi.org/10.1007/s40800-018-0081-4
Tepaev RF, Vishnevskiy VA, Kuzin SA, Sergey IV, Gordeeva OB, Pytal AV, Murashkin NN. Benzocaine-Induced Methemoglobinemia. A Clinical Case. Pediatricheskaya farmakologiya. 2018;15(5):396-401.(In Russ). https://doi.org/10.15690/pf.v15i5.1962
Wright RO, Lewander WJ, Woolf AD. Methemoglobinemia: etiology, pharmacology, and clinical management. Annals of Emergency Medicine. 1999;34(5):646-656. https://doi.org/10.1016/s0196-0644(99)70167-8
Kuiper-Prins E, Kerkhof GF, Reijnen CG, van Dijken PJ. A 12-dayold boy with methemoglobinemia after circumcision with local anesthesia (lidocaine/prilocaine). Drug Safety — Case Reports. 2016;3(1):12. https://doi.org/10.1007/s40800-016-0033-9
Iolascon A, Bianchi P, Andolfo I, Russo R, Barcellini W, Fermo E, Toldi G, Ghirardello S, Rees D, Van Wijk R, Kattamis A, Gallagher PG, Roy N, Taher A, Mohty R, Kulozik A, De Franceschi L, Gambale A, De Montalembert M, Forni GL, Harteveld CL, Prchal J; 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
Usryugov AYu, Kazanets EG, Zakharova GS, Plyasunova SA, Sadelov IO. 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. 2015;14(4):32-36. (In Russ.).
Paczek A, Wawrzyńska L, Mendek-Czajkowska E, Kober J, Torbicki A. [Acquired methemoglobinemia — case report]. Pneumonologia i Alergologia Polska. 2010;78(2):153-158.
Cannon RD, Wagner M, Jacoby JL. Troponin leak associated with drug-induced methemoglobinemia. American Journal of Emergency Medicine. 2014;32(10). https://doi.org/10.1016/j.ajem.2014.03.015
Wright RO, Lewander WJ, Woolf AD. Methemoglobinemia: etiology, pharmacology, and clinical management. Annals of Emergency Medicine. 1999;34(5):646-656. https://doi.org/10.1016/s0196-0644(99)70167-8
Rehmani A, Khachatoorian Y, De La Cruz Tejada A, et al. Severe methemoglobinemia clinically presenting as acute coronary syndrome. Journal of the American College of Cardiology. 2021;77(18 Suppl 1):1890. https://doi.org/10.1016/S0735-1097(21)03246-0
Mommers L, Delnoij TS, Strauch U. Under-the-counter acquired acute coronary syndrome: Methaemoglobinaemia. Journal of the American College of Cardiology. 2016;5(8):549-550. https://doi.org/10.1177/2048872615579394
Ludlow JT, Wilkerson RG, Nappe TM. Methemoglobinemia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; August 28, 2023. https://www.ncbi.nlm.nih.gov/books/NBK537317/
Shihana F, Dissanayake DM, Buckley NA, Dawson AH. A simple quantitative bedside test to determine methemoglobin. Annals of Emergency Medicine. 2010;55(2):184-189. https://doi.org/10.1016/j.annemergmed.2009.07.022
Novikova OV, Volchkov VA, Boyarkin AA, Atyukov MA. Efficacy and safety of regional anesthesia after thoracoscopic lobectomy. Russian Journal of Anesthesiology and Reanimatology. 2022;(6):68-74. (In Russ.). https://doi.org/10.17116/anaesthesiology202206168
Karelov AE, Vasilieva GN, Semkichev VA, Dimitrienko AI, Marova NG, Vasilev YI. Articaine using for out-hospital patients with side effects to lidocaine: a pilot study. Russian Journal of Anesthesiology and Reanimatology. 2022;(2):41-46. (In Russ.). https://doi.org/10.17116/anaesthesiology202202141
Ulrikh GE, Ryazanova OV, Zabolotskii DV, Pogorelchuk VV, Petrova KA. Spinal anesthesia during cesarean section in a patient with multi-support construction after previous correction of spinal deformity. Russian Journal of Anesthesiology and Reanimatology. 2023;(3):67-71. (In Russ.). https://doi.org/10.17116/anaesthesiology202303167
Andrianova TO, Ezhevskaya AA, Gerasimov SA, Zagrekov VI, Voennov OV. Optimal technique of postoperative analgesia in knee replacement surgery: a double-blind randomized study. Russian Journal of Anesthesiology and Reanimatology. 2023;(2):34-43. (In Russ.). https://doi.org/10.17116/anaesthesiology202302134
Chowdhary S, Bukoye B, Bhansali AM, Carbo AR, Adra M, Barnett S, Aronson MD, Leffler DA. Risk of topical anesthetic-induced methemoglobinemia: a 10-year retrospective case-control study. JAMA Internal Medicine. 2013;173(9):771-776. https://doi.org/10.1001/jamainternmed.2013.75
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. Archives of Internal Medicine. 2007;167(18):1977-1982. https://doi.org/10.1001/archinte.167.18.1977
Metivier F, Marchais SJ, Guerin AP, Pannier B, London GM. Pathophysiology of anaemia: focus on the heart and blood vessels. Nephrology, Dialysis, Transplantation. 2000;15(Suppl 3):14-18. https://doi.org/10.1093/oxfordjournals.ndt.a027970
Carson JL, Duff A, Poses RM, Berlin JA, Spence RK, Trout R, Noveck H, Strom BL. Effect of anaemia and cardiovascular disease on surgical mortality and morbidity. Lancet. 1996;348(9034):1055-1060. https://doi.org/10.1016/S0140-6736(96)04330-9
Boiarincev VV, Grebenyuk AN, Ostapenko YuN, Lodyagin AN. Organization of emergency medical care in acute poisoning of chemical etiology. Kremlevskaya meditsina. Klinicheskij vestnik. 2019;3:117-124. (In Russ).
Polozova EV, Shilov VV, Nikanov AN, Frolova NM. Features of the clinic of acute industrial carbon monoxide poisoning complicated by thermochemical lesions of the upper respiratory tract. Meditsina truda i promyshlennaya ekologiya. 2009;(4):14-18. (In Russ).
Meneveau N, Schiele F, Seronde MF, Descotes-Genon V, Oettinger J, Chopard R, Ecarnot F, Bassand JP; Reseau de Cardiologie de Franche Comte. Anemia for risk assessment of patients with acute coronary syndromes. The American Journal of Cardiology. 2009;103(4):442-447. https://doi.org/10.1016/j.amjcard.2008.10.023
Tsujita K, Nikolsky E, Lansky AJ, Dangas G, Fahy M, Brodie BR, Dudek D, Möckel M, Ochala A, Mehran R, Stone GW. Impact of anemia on clinical outcomes of patients with ST-segment elevation myocardial infarction in relation to gender and adjunctive antithrombotic therapy (from the HORIZONS-AMI trial). American Journal of Cardiology. 2010;105:1385-1394. https://doi.org/10.1016/j.amjcard.2010.01.001
Sulaiman K, Prashanth P, Al-Zakwani I, Al-Mahmeed W, Al-Motarreb A, Al Suwaidi J, Amin H, Asaad N, Hersi A, Al Faleh H, Al Saif S, Alsheikh-Ali AA, Al Lawati J, Al-Habib K. Impact of anemia on in-hospital, one-month and one-year mortality in patients with acute coronary syndrome from the Middle East. Clinical Medicine and Research 2012;10:65-71. https://doi.org/10.3121/cmr.2011.1032
Kunadian V, Mehran R, Lincoff AM, Feit F, Manoukian SV, Hamon M, Cox DA, Dangas GD, Stone GW. Effect of anemia on frequency of short- and long-term clinical events in acute coronary syndromes (from the Acute Catheterization and Urgent Intervention Triage Strategy Trial). American Journal of Cardiology. 2014;114(12):1823-1829. https://doi.org/10.1016/j.amjcard.2014.09.023
Puchinyan NF, Furman NV, Malinova LI, Dovgalevskiy YaP. Acute coronary syndrome and anemia: features of choosing the optimal medical tactics (review). Saratovskij nauchno-meditsinskij zhurnal. 2021;17(3):560-565. (In Russ). https://ssmj.ru/system/files/archive/2021/ssmj-2021-3-suppl-1-full.pdf

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