RT Journal Article
SR Electronic
T1 Methemoglobinemia in an Infant After Sclerotherapy With High-Dose Doxycycline
JF Pediatrics
JO Pediatrics
FD American Academy of Pediatrics
SP e20181642
DO 10.1542/peds.2018-1642
VO 143
IS 2
A1 Coughlin, Katherine
A1 Flibotte, John
A1 Cahill, Anne Marie
A1 Osterhoudt, Kevin
A1 Hedrick, Holly
A1 Vrecenak, Jesse
YR 2019
UL http://pediatrics.aappublications.org/content/143/2/e20181642.abstract
AB 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 Pao2 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.