Center for Injury Research and Prevention

Methemoglobinemia in an Infant After Sclerotherapy With High-Dose Doxycycline.

TitleMethemoglobinemia in an Infant After Sclerotherapy With High-Dose Doxycycline.
Publication TypeJournal Article
Year of Publication2019
AuthorsCoughlin K, Flibotte J, Cahill AM, Osterhoudt KC, Hedrick H, Vrecenak J
JournalPediatrics
Date Published01/2019
ISSN1098-4275
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 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.

DOI10.1542/peds.2018-1642
Alternate JournalPediatrics
PubMed ID30655334