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

IDCases

Rodrigo B.O. Lima¹  Lais C. Marques²  Felippe Lazar Neto³  Antonio Adolfo Guerra Soares Brandão³  Desirée Verde Lopes³ 

[1] Corresponding author at: Av Dr. Enéas Carvalho de Aguiar, 155, Deparment of Internal Medicine, Brazil.;Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av. Dr. Enéas Carvalho de Aguiar, 155, São Paulo, Brazil;Department of Internal Medicine, Hospital Dr. Moyses Deustche (Mboi Mirim), Estrada do Mboi Mirim, 5203, São Paulo, Brazil;

关键词: COVID-19;    Methemoglobinemia;    Hemolytic anemia;    Hypoxia;    SARS-CoV-2;   

DOI  :  

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown