What is the role of lab studies in the workup of methemoglobinemia?

Updated: Dec 09, 2018
  • Author: Mary Denshaw-Burke, MD, FACP; Chief Editor: Emmanuel C Besa, MD  more...
  • Print
Answer

Laboratory studies that may be ordered include the following:

  • Studies to rule out hemolysis – Complete blood count (CBC), reticulocyte counts, lactate dehydrogenase (LDH), indirect bilirubin, haptoglobin
  • Studies to test for organ failure and general end-organ dysfunction – Liver function tests, electrolyte concentrations, blood urea nitrogen (BUN), creatinine
  • Urine pregnancy tests
  • Heinz body preparation
  • Hemoglobin electrophoresis to identify hemoglobin M (Hb M); some difficult cases require DNA sequencing of the globin chain gene or mass spectrometry for diagnosis
  • Specific enzyme assays for causative deficiencies
  • Bedside tests for methemoglobinemia - Examination of blood color on white filter paper after exposure to room air or after aerating a tube of blood with 100% oxygen; if the blood remains dark with these maneuvers, then methemoglobinemia is likely
  • Serum levels of nitrites or other offending drugs

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!