Neonatal Acquired Methemoglobinemia – Can Broad Spectrum Antibiotics be Implicated?: Correspondence
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To the Editor: We read with interest the series of three neonatal cases of methemoglobinemia and found it very interesting . However, we would like to make certain points regarding the diagnosis and management of these cases which will be helpful for the readers while evaluating such neonates.
We feel that the cases were labeled as “acquired methemoglobinemia” without ruling out congenital/hereditary methemoglobinemia or identifying a convincing etiology. The hypothesis of the “broad-spectrum antibiotics used in these cases leading to methemoglobinemia” is not supported by the existing literature. Moreover, the biochemical properties of these antibiotics too, do not support their causative role in methemoglobinemia . Therefore, in such unexplained cases, the detailed evaluation of congenital causes of elevated methemoglobin (Cytochrome b5 reductase deficiency, Hemoglobin M disease, Cytochrome b5 deficiency) should be done. Hemoglobin electrophoresis, red blood cell enzyme...