METHEMOGLOBİNEMİ TEDAVİSİNDE METİLEN MAVİSİ KULLANILAN BİR YENİDOĞANDA CİDDİ HEMOLİZE BAĞLI SARILIK: OLGU SUNUMU

Siyanoz her yaşta görülmekle birlikte yenidoğanlarda görüldüğünde ayırıcı tanıda birçok faktörün düşünülmesini gerektiren fizik muayene bulgusudur. Fizyopatolojisine göre siyanoz ayırıcı tanıda iki gruba ayrılarak irdelenmelidir. İlki fizyolojik olmayan hemoglobin varlığında gözlenen siyanoz, diğeri ise deoksijenize hemoglobin düzeyinin yüksekliğinde gözlenen siyanozdur. Methemoglobinemi fizyolojik olmayan hemoglobin formudur ve ciddi kan düzeylerine ulaştığında siyanoza sebep olabilmektedir. Ayırıcı tanıda düşünülmesi gereken methemoglobinemi tanısı ve tedavisi kolay bir durumdur. Ünitemize doğumsan kısa süre sonra methemoglobinemiye bağlı santral siyanoz tanısı ile yatırılan ve metilen mavisi kullanılarak tedavi edilen ve izleminde hemolize bağlı ciddi hiperbilirubinemisi olan olgu sunulmuştur.

SEVERE HYPERBILURIBINEMIA DUE TO HEMOLYSIS DURING TREATMENT OF METHEMOGLOBINEMIA: CASE REPORT

Cyanosis is a physical finding of multiple causes that poses the greatest diagnostic and management chal- lenges when it involves the newborn infant. The differential diagnosis of cyanosis therefore can be separated into two major groups: The first one is non-physiologic disorders of hemoglobin and the second one is disorders involving deoxygenated hemoglobin. Non-physiologic forms of hemoglobin such as methemoglobin can also cause cyanosis when present in significant amounts. Methemoglobinemia is the one of easly diagnosed and treated clinic situations. We herein present a newborn with methemoglobinemia who was treated by methylen blue and developed serious hyperbilirubinemia due to hemolysis.

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