Abstract
Cyanosis associated to low oxygen saturation may reveal hemoglobin pathology. A 3 year-old child had a nephroblastoma with pleural effusion. He suddenly developed persistent cyanosis despite pleural effusion drainage; transcutaneous and measured oxygen saturations were low and PaO 2 on arterial blood gases was high. Methemoglobinemia was diagnosed, due to prilocaine-lignocaine cream used for local anesthesia, associated to partial G6PD deficiency. The methemoglobinemia disappeared after methylene blue treatment. Cyanosis with low oxygen saturation and high or normal PaO 2 should lead to the search of a hemoglobin pathology, especially methemoglobinemia by appropriate methods.
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