What is the role of exchange transfusion in the treatment of methemoglobinemia?

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

Exchange transfusion (which replaces abnormal hemoglobin with normal hemoglobin) may be considered for G6PD-deficient patients who are severely symptomatic or unresponsive to methylene blue. Patients who are on long-acting medication (eg, dapsone) may have initial treatment success with subsequent relapse of symptoms. Gastric lavage followed by charcoal administration may decrease this prolonged drug effect. These patients should be monitored closely and retreated with methylene blue as necessary.


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