XIV.a

Methemoglobinemia

See also under XIVa. Known since the 1940s (PMID 18883450). Comprehensive list of causal drugs and chemicals available at PMID 1564446. Methemoglobin is the oxidized (Fe3+) species of hemoglobin (Fe2+). Patients present with slate-grey cyanosis, low SpO2, normal SaO2 and PaO2. Normally, methemoglobin is <1%. Levels above 40% can be life-threatening, producing pulmonary edema, cardiovascular collapse (PMID 17122537) CNS disturbances and death. Management includes i.v. methylene blue. A possible rebound increase in MeHb upon treatment requires close monitoring. Excess methylene blue can also produce methemoglobinemia

Last update : 16/10/2014
 

Causative drugs

70

Chemicals

I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD)
I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia (or a consistent migratory OP pattern on imaging)
I.j I - Interstitial/parenchymal lung disease
I.j - Exogenous lipoid pneumonia
I.af I - Interstitial/parenchymal lung disease
I.af - Chemical pneumonitis
II.a II - Pulmonary edema - ARDS - Acute respiratory failure
II.a - Pulmonary edema, noncardiogenic (NCPE)
II.b II - Pulmonary edema - ARDS - Acute respiratory failure
II.b - ARDS
III.a III - Pulmonary hemorrhage
III.a - Alveolar hemorrhage
III.b III - Pulmonary hemorrhage
III.b - Pneumorenal syndrome
IV.c IV - Airway involvement
IV.c - Obliterative bronchiolitis (see also IVn)
IV.n IV - Airway involvement
IV.n - Obstructive airway dysfunction (see also IVc)
IV.q IV - Airway involvement
IV.q - Reactive airway dysfunction syndrome (RADS)
V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion
VIII.c VIII - Upper, central, large airway involvement
VIII.c - Upper airway obstruction other than angioedema or hematoma
VIII.h VIII - Upper, central, large airway involvement
VIII.h - Vocal cord dysfunction, adduction, closure
X.m X - Systemic reactions, syndromes and conditions
X.m - Pulmonary/systemic vasculopathy/vasculitis (ANCA status MPO, unknown or negative)
X.u X - Systemic reactions, syndromes and conditions
X.u - Multiple organ dysfunction/failure (MODS/MOF)
X.ac X - Systemic reactions, syndromes and conditions
X.ac - Anti-GBM antibody disease (Goodpasture-like) or flare of
XI.s XI - Miscellaneous
XI.s - Death following inhalation of compound - Sniffing death
XII.m XII - Cardiovascular involvement / toxicity
XII.m - Cardiac/cardiopulmonary arrest
XIV.a XIV - Hemoglobinopathies-Abnormal hemoglobins states (acquired)
XIV.a - Methemoglobinemia
XIV.b XIV - Hemoglobinopathies-Abnormal hemoglobins states (acquired)
XIV.b - Sulfhemoglobinemia
XV.x XV - Pulmonary pathology
XV.x - Path: Acute or subacute bronchiolitis (see also IVc, IVi)
XVI.ab XVI - Imaging
XVI.ab - Imaging: Cavitating lung nodules (see also Iq, XIs, XIIi, XVIaa and XVIIp)
XVII.p XVII - Infections & related conditions
XVII.p - Lung abscess/abscesses (see also VIr)
5

Chloroquine

I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD)
I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)
I.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP)
II.b II - Pulmonary edema - ARDS - Acute respiratory failure
II.b - ARDS
IX.a IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.a - Diaphragm/inspiratory muscle weakness/paralysis (w/wo ARF)
IX.i IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.i - Respiratory arrest - Apnea
X.a X - Systemic reactions, syndromes and conditions
X.a - DRESS (drug rash eosinophilia and hypersensitivity syndrome)
XI.r XI - Miscellaneous
XI.r - Death following exposure or poisoning
XII.f XII - Cardiovascular involvement / toxicity
XII.f - Cardiomyopathy (acute, subacute, chronic)
XII.h XII - Cardiovascular involvement / toxicity
XII.h - Eosinophilic myocarditis
XII.l XII - Cardiovascular involvement / toxicity
XII.l - Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP)
XII.m XII - Cardiovascular involvement / toxicity
XII.m - Cardiac/cardiopulmonary arrest
XII.s XII - Cardiovascular involvement / toxicity
XII.s - Heart block (bundle branch- or AV-)
XIV.a XIV - Hemoglobinopathies-Abnormal hemoglobins states (acquired)
XIV.a - Methemoglobinemia
XV.b XV - Pulmonary pathology
XV.b - Path: Eosinophilic pneumonia (subacute or acute) (see also Ic)
XIX.c XIX - Cytology, biochemistry of BAL, pleural fluid or FNA
XIX.c - BAL: An excess proportion of eosinophils
1

Hydrocarbons (paraffin, petrolatum, liquid petrochemicals, naphta, kerosene, jet fuel, Diesel), aspirated

I.j I - Interstitial/parenchymal lung disease
I.j - Exogenous lipoid pneumonia
I.z I - Interstitial/parenchymal lung disease
I.z - Areas of consolidation
I.af I - Interstitial/parenchymal lung disease
I.af - Chemical pneumonitis
I.ag I - Interstitial/parenchymal lung disease
I.ag - Fire-eater's lung or -pneumonitis
II.b II - Pulmonary edema - ARDS - Acute respiratory failure
II.b - ARDS
III.a III - Pulmonary hemorrhage
III.a - Alveolar hemorrhage
V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion
VIII.d VIII - Upper, central, large airway involvement
VIII.d - Thermal (burns, frostbite), chemical, or caustic facial and/or airway injury
XI.b XI - Miscellaneous
XI.b - Chest pain (acute - subacute)
XI.s XI - Miscellaneous
XI.s - Death following inhalation of compound - Sniffing death
XIV.a XIV - Hemoglobinopathies-Abnormal hemoglobins states (acquired)
XIV.a - Methemoglobinemia
XV.as XV - Pulmonary pathology
XV.as - Path: Fire eater's lung
XVI.f XVI - Imaging
XVI.f - Imaging: Bibasilar opacities/shadowing
XVI.k XVI - Imaging
XVI.k - Imaging: An area or areas of consolidation
XVI.ab XVI - Imaging
XVI.ab - Imaging: Cavitating lung nodules (see also Iq, XIs, XIIi, XVIaa and XVIIp)
XVI.ah XVI - Imaging
XVI.ah - Imaging: Pneumatoceles (see also XVIaf)
XIX.a XIX - Cytology, biochemistry of BAL, pleural fluid or FNA
XIX.a - BAL: An excess proportion of lymphocytes
XIX.h XIX - Cytology, biochemistry of BAL, pleural fluid or FNA
XIX.h - BAL: Lipid vacuoles in BAL alveolar macrophages
2