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SHORT COMMUNICATION
Year : 2011  |  Volume : 3  |  Issue : 4  |  Page : 543-545

Blue cures blue but be cautious


1 Department of Pharmacology, LLRM Medical College, Muradnagar (Ghaziabad), India
2 Department of Medicine, IDST, Muradnagar (Ghaziabad), India
3 Departments of Oral Pathology and Microbiology, ITS- CDSR, Muradnagar (Ghaziabad), India
4 Consultant dermatologist, Lokpriya Hospital, Meerut, Uttar Pradesh, India

Correspondence Address:
Pranav Sikka
Department of Pharmacology, LLRM Medical College, Muradnagar (Ghaziabad)
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-7406.90112

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Methemoglobinemia is a disorder characterized by the presence of >1% methemoglobin (metHb) in the blood. Spontaneous formation of methemoglobin is normally counteracted by protective enzyme systems, for example, nicotinamide adenine dinucleotide phosphate (NADPH) methemoglobin reductase. Methemoglobinemia is treated with supplemental oxygen and methylene blue (1-2 mg/kg) administered slow intravenously, which acts by providing an artificial electron acceptor for NADPH methemoglobin reductase. But known or suspected glucose-6-phosphate dehydrogenase (G6PD) deficiency is a relative contraindication to the use of methylene blue because G6PD is the key enzyme in the formation of NADPH through pentose phosphate pathway and G6PD-deficient individuals generate insufficient NADPH to efficiently reduce methylene blue to leukomethylene blue, which is necessary for the activation of the NADPH-dependent methemoglobin reductase system. So, we should be careful using methylene blue in methemoglobinemia patient before G6PD levels.


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