Cyanosis brownR23.8

Brownish cyanosis in methemoglobinemia (iron in III-valent form). Triggered by therapy with sulfones/sulfonamides ( DADPS) or nitrites (nitrate-containing heart medication!), in case of G6PD deficiency, by nitrosegases, bitter almond products, hemoglobinopathies. In the laboratory, brown blood colour is impressive, which does not disappear when shaken. Met-Hb determination is positive. Heinz's inner body is found in the erythrocytes.

Administration of vitamin C: 500-1000 mg single dose, repeated if necessary. Alternatively: administration of methylene blue 2%, 10 ml i.v., repeat 1-2 times if necessary. Stop triggering medication, monitor the patient. Caution! Hemolysis! Hb control, if necessary substitution of erythrocyte concentrates.