Belgian Journal of Paediatrics
Unexplained neonatal cyanosis: don’t forget the dyshemoglobinemias
Vol. 23 No. 4 (2021), Review articles
Vol. 23 No. 4 (2021)

Unexplained neonatal cyanosis: don’t forget the dyshemoglobinemias

Review articles
Published 2022-01-09 — Updated on 2023-01-18
Karen Van Mechelen
University of Antwerp, Antwerp University Hospital, department of Neonatology, Drie Eikenstraat 655, 2650 Edegem, Belgium
Mariska de Lausnay
University of Antwerp, Antwerp University Hospital, department of Pediatrics, Drie Eikenstraat 655, 2650 Edegem, Belgium
Bart Peeters
University of Antwerp, Antwerp University Hospital, department of clinical biology, Drie Eikenstraat 655, 2650 Edegem, Belgium
Michiel Voeten
University of Antwerp, Antwerp University Hospital, department of Neonatology, Drie Eikenstraat 655, 2650 Edegem, Belgium
Antonius Mulder
University of Antwerp, Antwerp University Hospital, department of Neonatology, Drie Eikenstraat 655, 2650 Edegem, Belgium
Philip Maes
University of Antwerp, Antwerp University Hospital, department of Pediatrics, Drie Eikenstraat 655, 2650 Edegem, Belgium
Marisse Meeus
University of Antwerp, Antwerp University Hospital, department of Neonatology, Drie Eikenstraat 655, 2650 Edegem, Belgium

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Keywords

methemoglobinemia
sulhemoglobinemia
infant
saturation gap
cyanosis

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How to Cite

Van Mechelen, K., de Lausnay, M., Peeters, B., Voeten, M., Mulder, A., Maes, P., & Meeus, M. (2023). Unexplained neonatal cyanosis: don’t forget the dyshemoglobinemias. Belgian Journal of Paediatrics, 23(4), 299–301. Retrieved from http://belgjpaediatrics.com/index.php/bjp/article/view/105 (Original work published January 9, 2022)
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Abstract

The diagnosis of dyshemoglobinemias is a challenge. A high index of suspicion is required in neonates with central cyanosis out of proportion to the oxygen saturation, not responding to supplemental oxygen and an oxygen saturation gap exceeding 5%. Gold standard for the diagnosis is co-oximetry. We report two neonates with rare forms of dyshemoglobinemias. The first neonate has a, probably congenital, methemoglobinemia and was treated with methylene blue (rescue treatment) and vitamin B2 (maintenance therapy). The second neonate had a sulfhemoglobinemia due to Escherichia coli and was treated with blood transfusions. Early recognition of dyshemoglobinemias is vital because early therapy is life-saving.

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