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Methemoglobinemia and hemolytic anemia after COVID-19 infection without identifiable eliciting drug: A case-report

We report a second case of methemoglobinemia and non-autoimmune hemolytic anemia after contracting the SARS-CoV-2 infection in the absence of an identifiable eliciting drug. A 35-year old male without previous known comorbidities was admitted after he was diagnosed with the COVID-19 infection and ha...

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Autores principales: Lopes, Desirée Verde, Lazar Neto, Felippe, Marques, Lais C., Lima, Rodrigo B.O., Brandão, Antonio Adolfo Guerra Soares
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676365/
https://www.ncbi.nlm.nih.gov/pubmed/33235826
http://dx.doi.org/10.1016/j.idcr.2020.e01013
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author Lopes, Desirée Verde
Lazar Neto, Felippe
Marques, Lais C.
Lima, Rodrigo B.O.
Brandão, Antonio Adolfo Guerra Soares
author_facet Lopes, Desirée Verde
Lazar Neto, Felippe
Marques, Lais C.
Lima, Rodrigo B.O.
Brandão, Antonio Adolfo Guerra Soares
author_sort Lopes, Desirée Verde
collection PubMed
description We report a second case of methemoglobinemia and non-autoimmune hemolytic anemia after contracting the SARS-CoV-2 infection in the absence of an identifiable eliciting drug. A 35-year old male without previous known comorbidities was admitted after he was diagnosed with the COVID-19 infection and had large pulmonary involvement. Seven days later, he desaturated but was without any signs of respiratory distress. A check of arterial blood gas revealed normal partial pressure of oxygen and follow-up tests confirmed a methemoglobinemia diagnosis. Over the next few days, hemolysis was established after decreased levels of hemoglobin and increased levels of indirect bilirubin and lactate dehydrogenase. A hemolytic anemia investigation panel came back normal, including G6PD. A second G6PD test was ordered at the 5-month follow-up appointment and revealed decreased levels. Clinicians should thus be aware of possible false negative tests when testing for G6PD during hemolytic crisis. In addition, whether the COVID-19 infection alone would be responsible for this chain of events remains a challenging question.
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spelling pubmed-76763652020-11-20 Methemoglobinemia and hemolytic anemia after COVID-19 infection without identifiable eliciting drug: A case-report Lopes, Desirée Verde Lazar Neto, Felippe Marques, Lais C. Lima, Rodrigo B.O. Brandão, Antonio Adolfo Guerra Soares IDCases Case Report We report a second case of methemoglobinemia and non-autoimmune hemolytic anemia after contracting the SARS-CoV-2 infection in the absence of an identifiable eliciting drug. A 35-year old male without previous known comorbidities was admitted after he was diagnosed with the COVID-19 infection and had large pulmonary involvement. Seven days later, he desaturated but was without any signs of respiratory distress. A check of arterial blood gas revealed normal partial pressure of oxygen and follow-up tests confirmed a methemoglobinemia diagnosis. Over the next few days, hemolysis was established after decreased levels of hemoglobin and increased levels of indirect bilirubin and lactate dehydrogenase. A hemolytic anemia investigation panel came back normal, including G6PD. A second G6PD test was ordered at the 5-month follow-up appointment and revealed decreased levels. Clinicians should thus be aware of possible false negative tests when testing for G6PD during hemolytic crisis. In addition, whether the COVID-19 infection alone would be responsible for this chain of events remains a challenging question. Elsevier 2020-11-19 /pmc/articles/PMC7676365/ /pubmed/33235826 http://dx.doi.org/10.1016/j.idcr.2020.e01013 Text en © 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Lopes, Desirée Verde
Lazar Neto, Felippe
Marques, Lais C.
Lima, Rodrigo B.O.
Brandão, Antonio Adolfo Guerra Soares
Methemoglobinemia and hemolytic anemia after COVID-19 infection without identifiable eliciting drug: A case-report
title Methemoglobinemia and hemolytic anemia after COVID-19 infection without identifiable eliciting drug: A case-report
title_full Methemoglobinemia and hemolytic anemia after COVID-19 infection without identifiable eliciting drug: A case-report
title_fullStr Methemoglobinemia and hemolytic anemia after COVID-19 infection without identifiable eliciting drug: A case-report
title_full_unstemmed Methemoglobinemia and hemolytic anemia after COVID-19 infection without identifiable eliciting drug: A case-report
title_short Methemoglobinemia and hemolytic anemia after COVID-19 infection without identifiable eliciting drug: A case-report
title_sort methemoglobinemia and hemolytic anemia after covid-19 infection without identifiable eliciting drug: a case-report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676365/
https://www.ncbi.nlm.nih.gov/pubmed/33235826
http://dx.doi.org/10.1016/j.idcr.2020.e01013
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