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September 1984

Alert: Perioperative Neonatal Methemoglobinemia

Author Affiliations

Department of Pediatrics University of Arizona Health Sciences Center Tucson, AZ 85724; Department of Pediatrics State University of New York Upstate Medical Center Crouse-Irving Memorial Hospital Syracuse, NY 13210

Am J Dis Child. 1984;138(9):889-890. doi:10.1001/archpedi.1984.02140470087031

We were notified of the severe and unexpected occurrence of methemoglobinemia in infants in Tucson and Syracuse, NY. This letter to the editor was rapidly processed so that physicians are alerted to this unusual event.—Ed.

Sir.—We wish to alert readers of the AJDC to a series of three unrelated neonatal patients from two institutions who underwent surgery and suffered severe unexpected perioperative methemoglobinemia. Methemoglobin is an abnormal oxidation product of hemoglobin in which the iron moiety exists in the ferric state, unable to bind and transport elemental oxygen reversibly. Methemoglobinemia can be caused by inherited defects of hemoglobin metabolism or by exogenous environmental agents.

Report of Cases.—Case 1.—A 1,500-g 33-week gestational age female infant had a postnatal course complicated by an omphalocele and severe respiratory distress syndrome. Primary surgical repair was not possible, and a Silastic prosthesis was placed on the first day of life