sulfhemoglobinemia

スルホヘモグロビン血症

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/30 16:41:34」(JST)

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Sulfhemoglobinemia
Classification and external resources
Specialty	hematology
ICD-10	D74.8
ICD-9-CM	289.7
MedlinePlus	003371
MeSH	D013436

Sulfhemoglobinemia (or sulfhaemoglobinaemia) is a rare condition in which there is excess sulfhemoglobin (SulfHb) in the blood. The pigment is a greenish derivative of hemoglobin which cannot be converted back to normal, functional hemoglobin. It causes cyanosis even at low blood levels.

It is a rare blood condition that occurs when a sulfur atom is incorporated into the hemoglobin molecule. When hydrogen sulfide (H₂S) (or sulfide ions) and ferric ions combine in the blood, the blood is incapable of carrying oxygen.

Causes

This can be caused by taking medications that contain sulfonamides under certain conditions (i.e., overdosing of sumatriptan).

Sulfhemoglobinemia is usually drug induced. Drugs associated with sulfhemoglobinemia include acetanilid, phenacetin, nitrates, trinitrotoluene and sulfur compounds (mainly sulphonamides, sulfasalazine). Another possible cause is occupational exposure to sulfur compounds.

It can be caused by phenazopyridine.

Prognosis and treatment

The condition generally resolves itself with erythrocyte (red blood cell) turnover, although blood transfusions can be necessary in extreme cases.

Presentation

Symptoms include a blueish or greenish discoloration of the blood, skin, and mucous membranes, even though a blood count test may not show any abnormalities in the blood. This discoloration is called cyanosis, and is caused by greater than 5 grams per cent of deoxyhemaglobinemia, or 1.5 grams per cent of methemaglobinemia, or 0.5 grams per cent of sulphemaglobinemia, all serious medical abnormalities.

Notable cases

On June 8, 2007, Canadian anesthesiologists Dr. Stephan Schwarz, Dr. Giuseppe Del Vicario, and Dr. Alana Flexman presented an unusual case in The Lancet. A 42-year-old male patient was brought into Vancouver's St. Paul's Hospital after falling asleep in a kneeling position, which caused compartment syndrome and a buildup of pressure in his legs. When doctors drew the man's blood prior to performing the surgery to relieve the pressure from the man's legs, they noted his blood was green. A sample of the blood was immediately sent to a lab. In this case, sulfhemoglobinaemia was possibly caused by the patient taking higher-than-prescribed doses of sumatriptan.

References

External links

• Biology Online
• Cancer Web Project Online Medical Dictionary

UpToDate Contents

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• 1. ヘモグロビンの酸素親和性に関する遺伝性疾患 genetic disorders of hemoglobin oxygen affinity
• 2. 毒物除去の強化 enhanced elimination of poisons

English Journal

• On the noninvasive optical monitoring and differentiation of methemoglobinemia and sulfhemoglobinemia.

• Baranoski GV1, Chen TF, Kimmel BW, Miranda E, Yim D.Author information 1University of Waterloo, Natural Phenomena Simulation Group, School of Computer Science, 200 University Avenue West, Waterloo, Ontario, Canada N2L 3G1. gvgbaran@curumin.math.uwaterloo.caAbstractThere are several pathologies whose study and diagnosis is impaired by a relatively small number of documented cases. A practical approach to overcome this obstacle and advance the research in this area consists in employing computer simulations to perform controlled in silico experiments. The results of these experiments, in turn, may be incorporated in the design of differential protocols for these pathologies. Accordingly, in this paper, we investigate the spectral responses of human skin affected by the presence of abnormal amounts of two dysfunctional hemoglobins, methemoglobin and sulfhemoglobin, which are associated with two life-threatening medical conditions, methemoglobinemia and sulfhemoglobinemia, respectively. We analyze the results of our in silico experiments and discuss their potential applications to the development of more effective noninvasive monitoring and differentiation procedures for these medical conditions.
• Journal of biomedical optics.J Biomed Opt.2012 Sep;17(9):97005. doi: 10.1117/1.JBO.17.9.097005.
• There are several pathologies whose study and diagnosis is impaired by a relatively small number of documented cases. A practical approach to overcome this obstacle and advance the research in this area consists in employing computer simulations to perform controlled in silico experiments. The resul
• PMID 22975680

• [A rare cause of cyanosis: Sulphaemoglobinaemia related to thiocolchicoside (Miorel)].

• Dupouy J1, Petureau F, Montastruc JL, Oustric S, Degano B.Author information 1Service de pneumologie, centre hospitalier de Montauban, 100, rue Léon-Cladel, 82013 Montauban cedex, France.AbstractINTRODUCTION: An acquired abnormality of haemoglobin is among the many causes of cyanosis, especially in patients with no identified cardiorespiratory cause.
• Revue des maladies respiratoires.Rev Mal Respir.2010;27(1):80-3. doi: 10.1016/j.rmr.2009.10.006. Epub 2009 Dec 8.
• INTRODUCTION: An acquired abnormality of haemoglobin is among the many causes of cyanosis, especially in patients with no identified cardiorespiratory cause.CASE REPORT: A 50-year-old woman, suffering from amyotrophic lateral sclerosis, was hospitalised for dyspnoea. Physical examination revealed cy
• PMID 20146957

• International perspective from singapore on "methemoglobinemia and sulfhemoglobinemia in two pediatric patients after ingestion of hydroxylamine sulfate".

• Lim HC1, Tan HH.
• The western journal of emergency medicine.West J Emerg Med.2009 Aug;10(3):202.
• PMID 19718386

Japanese Journal

• 硫黄入浴剤服用による中毒死の1症例

• 蘇生 21(2), 35-37, 2002-08-10
• NAID 10009652474

• 諸種薬物によるスルフヘモグロビン形成に関する研究　ＩＶ　　化学物質誘起異常血色素症におよぼす各種治療剤の影響:―化学物質誘起異常血色素症におよぼす各種治療剤の影響―

• 日本薬理学雑誌 76(6), 435-446, 1980
• NAID 130000759252

• 諸種薬物によるスルホヘモグロビン形成に関する研究　ＩＩ

• 日本薬理学雑誌 73(4), 423-435, 1977
• NAID 130000758754

Related Links

• Sulfhemoglobinemia - Wikipedia, the free encyclopedia

Sulfhemoglobinemia (or sulfhemoglobinaemia) is a rare condition in which there is excess sulfhemoglobin (SulfHb) in the blood. The pigment is a greenish derivative of hemoglobin which cannot be converted back to normal, functional ...

• The Unusual Case Of The Man With The Green Blood

8 Jun 2007 ... They turned to the rare sulfhemoglobinemia, rather than classic cyanosis, as the cause of the green-black blood. Sulfhemoglobinemia happens when a sulphur atom is incorporated into the hemoglobin molecule, and it can be ...

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