Methemoglobinemia in an infant after sclerotherapy with high-dose doxycycline

Katherine Coughlin, John Flibotte, Anne Marie Cahill, Kevin Osterhoudt, Holly Hedrick, Jesse Vrecenak

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Methemoglobinemia occurs when the heme moiety of hemoglobin (Hb) is oxidized from the ferrous to ferric state, leading to impairments in oxygen transport and delivery. Methemoglobinemia is rare in pediatric patients but has been described in the setting of congenital abnormalities in the Hb structure, inherited enzyme deficiencies, oxidative Hb injury in response to illness, and oxidative Hb injury due to toxicants. We present a 1-week-old infant born with a cervical lymphangioma who developed persistent desaturations that were unresponsive to oxygen after sclerotherapy with doxycycline. Arterial blood gas revealed a high PaO 2 despite low saturations being found on pulse oximetry and a methemoglobin level that was found to be elevated. Further sclerotherapy was discontinued, the saturations eventually normalized, and the methemoglobin level decreased. This is a novel report of sclerotherapy with doxycycline associated with the development of methemoglobinemia.

Original languageEnglish
Article numbere20181642
JournalPediatrics
Volume143
Issue number2
DOIs
StatePublished - Feb 2019

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