Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Pediatric Nephrology
Published in: Pediatric Nephrology 6/2014

01-06-2014 | Clinical Quiz

Cyanosis in a male Nigerian infant with acute kidney injury: Answers

Authors: Jasmin Pansy, Christoph J. Mache, Gerfried Zobel, Gernot Grangl, Ekkehard Ring, K. Martin Hoffmann

Published in: Pediatric Nephrology | Issue 6/2014

Login to get access

Excerpt

1.
Oxygen-resistant cyanosis in the absence of cardiorespiratory causes indicates methemoglobinemia. This patient developed methemoglobinemia as a consequence of rasburicase therapy in the setting of glucose-6-phosphate dehydrogenase (G6PD) deficiency.
 
2.
A blood gas analyzer can reliably measure the hemoglobin (Hb) subfractions in an arterial blood sample, including methemoglobin (metHb), with the spectrophotometric method. G6PD deficiency can be diagnosed biochemically or by molecular analysis of the G6PD gene.
 
3.
Patients of African, Asian, Mediterranean and Middle Eastern descent, as well as patients with a history and/or family history of unexplained cyanosis, hemolytic anemia, or unexplained jaundice are particularly at risk for G6PD deficiency and should be screened for this enzyme deficiency prior to rasburicase administration.
 
…
Literature
1.
Haymond S, Cariappa R, Eby CS, Scott MG (2005) Laboratory assessment of oxygenation in methemoglobinemia. Clin Chem 51:434–444PubMedCrossRef
2.
Clark TG, Fry AE, Auburn S, Campino S, Diakite M, Green A, Richardson A, Teo YY, Small K, Wilson J, Jallow M, Sisay-Joof F, Pinder M, Sabeti P, Kwiatkowski DP, Rockett KA (2009) Allelic heterogeneity in G6PD deficiency in West Africa and severe malaria susceptibility. Eur J Hum Genet 17:1080–1085PubMedCentralPubMedCrossRef
3.
4.
Cairo MS, Coiffier B, Reiter A, Younes A, TLS Expert panel (2010) Recommendations for the evaluation of risk and prophylaxis of tumour lysis syndrome (TLS) in adults and children with malignant diseases: an expert TLS panel consensus. Br J Haematol 149:578–586PubMedCrossRef
5.
Jarmoliński T, Zaniew M, Tousty J, Runowski D (2012) Is it the right time to subject children with acute kidney injury to rasburicase trials? Pediatr Nephrol 27:1201–1202PubMedCrossRef
6.
Acosta AA, Hogg RJ (2012) Rasburicase for hyperuricemia in hemolytic uremic syndrome. Pediatr Nephrol 27:325–329PubMedCrossRef
7.
Hobbs DJ, Steinke JM, Chung JY, Barletta GM, Bunchman TE (2010) Rasburicase improves hyperuricemia in infants with acute kidney injury. Pediatr Nephrol 25:305–309PubMedCrossRef
8.
Ghirardello S, Ardissino G, Mastrangelo A, Mosca F (2010) Rasburicase in the treatment of hyperuricemia of newborns. Pediatr Nephrol 25:1775PubMedCrossRef
9.
Canpolat FE, Cekmez F (2011) Rasburicase for hyperuricemia in an extremely low birth weight infant. Indian Pediatr 48:573–574PubMed
10.
Youngster I, Arcavi L, Schechmaster R, Akayzen Y, Popliski H, Shimonov J, Beig S, Berkovitch M (2010) Medications and glucose-6-phosphate dehydrogenase deficiency: an evidence-based review. Drug Saf 33:713–726PubMedCrossRef
11.
Titheradge H, Nolan K, Sivakumar S, Bandi S (2011) Methaemoglobinaemia with G6PD deficiency: rare cause of persistently low saturations in neonates. Acta Paediatr 100:e47–e48PubMedCrossRef
12.
Bauters T, Mondelaers V, Robays H, De Wilde H, Benoit Y, De Moerloose B (2011) Methemoglobinemia and hemolytic anemia after rasburicase administration in a child with leukemia. Int J Clin Pharm 33:58–60PubMedCrossRef
13.
Kizer N, Martinez E, Powell M (2006) Report of two cases of rasburicase-induced methemoglobinemia. Leuk Lymphoma 47:2648–2650PubMedCrossRef
14.
Schuurman M, van Waardenburg D, Da Costa J, Niemarkt H, Leroy P (2009) Severe hemolysis and methemoglobinemia following fava bean ingestion in glucose-6-phosphatase dehydrogenase deficiency: case report and literature review. Eur J Pediatr 168:779–782PubMedCrossRef
15.
Ng JS, Edwards EM, Egelund TA (2012) Methemoglobinemia induced by rasburicase in a pediatric patient: a case report and literature review. J Oncol Pharm Pract 18:425–431PubMedCrossRef
Metadata
Title
Cyanosis in a male Nigerian infant with acute kidney injury: Answers
Authors
Jasmin Pansy
Christoph J. Mache
Gerfried Zobel
Gernot Grangl
Ekkehard Ring
K. Martin Hoffmann
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 6/2014
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-013-2568-7

Other articles of this Issue 6/2014

Pediatric Nephrology 6/2014 Go to the issue

Original Article

Urinary MCP-1/creatinine in Henoch–Schönlein purpura and its relationship with nephritis

Original Article

Conversion from twice- to once-daily tacrolimus in pediatric kidney recipients: a pharmacokinetic and bioequivalence study

Original Article

Extrarenal sequential organ failure assessment score as an outcome predictor of critically ill children on continuous renal replacement therapy

Obituary

Professor Martin Barratt 1936–2014

Clinical Quiz

Cyanosis in a male Nigerian infant with acute kidney injury: Questions

Brief Report

N-acetyl-cysteine is associated to renal function improvement in patients with nephropathic cystinosis