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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Case Report

Methemoglobinemia in an Infant After Sclerotherapy With High-Dose Doxycycline

Katherine Coughlin, John Flibotte, Anne Marie Cahill, Kevin Osterhoudt, Holly Hedrick and Jesse Vrecenak
Pediatrics February 2019, 143 (2) e20181642; DOI: https://doi.org/10.1542/peds.2018-1642
Katherine Coughlin
aChildren’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
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John Flibotte
aChildren’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
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Anne Marie Cahill
aChildren’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
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Kevin Osterhoudt
aChildren’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
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Holly Hedrick
aChildren’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
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Jesse Vrecenak
bSt Louis Children’s Hospital, St Louis, Missouri
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  • FIGURE 1
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    FIGURE 1

    MRI of the neck, with contrast revealing a large cervical lymphangioma without impingement or involvement of the airway.

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    FIGURE 2

    Patient Fio2 and Hb-oxygen saturation on transcutaneous pulse-oximetry over time postsclerotherapy.

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    FIGURE 3

    Patient Hb and unconjugated bilirubin trends over time.

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    TABLE 1

    Examples of Some Common Drugs Associated With Methemoglobinemia in Pediatrics

    Common Less Common
    Benzocaine (topical)Sulfonamides
    PrilocaineAmethocaine
    NitritesCetacaine
    DapsoneTetracaine
    PrimaquineNitrates
    PhenacetinMethylene blue
    PhenazopyridineMetodopramide
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Pediatrics
Vol. 143, Issue 2
1 Feb 2019
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Methemoglobinemia in an Infant After Sclerotherapy With High-Dose Doxycycline
Katherine Coughlin, John Flibotte, Anne Marie Cahill, Kevin Osterhoudt, Holly Hedrick, Jesse Vrecenak
Pediatrics Feb 2019, 143 (2) e20181642; DOI: 10.1542/peds.2018-1642

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Methemoglobinemia in an Infant After Sclerotherapy With High-Dose Doxycycline
Katherine Coughlin, John Flibotte, Anne Marie Cahill, Kevin Osterhoudt, Holly Hedrick, Jesse Vrecenak
Pediatrics Feb 2019, 143 (2) e20181642; DOI: 10.1542/peds.2018-1642
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