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      Life-Threatening Extreme Methemoglobinemia during Standard Dose Nitric Oxide Therapy.

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          Abstract

          We report the first case of life-threatening extreme neonatal-acquired methemoglobinemia that occurred during inhaled nitric oxide (iNO) at the standard 20 ppm dose in a neonate with early onset sepsis and suprasystemic pulmonary hypertension. Life-threatening methemoglobinemia has been efficaciously treated with methylene blue and ascorbic acid, while stopping iNO and starting iloprost and sildenafil. The patient was subjected to various tests (including gene sequencing and hemoglobin electrophoresis) and did not have any known genetic cause or predisposition for methemoglobinemia. Neuroimaging and the 2-year clinical follow-up were completely normal.

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          Author and article information

          Journal
          Neonatology
          Neonatology
          S. Karger AG
          1661-7819
          1661-7800
          2019
          : 116
          : 3
          Affiliations
          [1 ] Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, South Paris University Hospitals, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France, robertacentorrino@hotmail.it.
          [2 ] Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, South Paris University Hospitals, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.
          [3 ] Physiopathology and Therapeutic Innovation Unit - INSERM U999, South Paris-Saclay University, Paris, France.
          Article
          000501462
          10.1159/000501462
          31454813
          26cf2ff5-7582-4ea4-aeb7-8109aadeca09
          History

          Sildenafil,Standard dose,Nitric oxide,Methemoglobinemia,Iloprost

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