Due to methemoglobin, a form of hemoglobin with ferric rather than ferrous iron, leading to impaired oxygen delivery to tissues.Encyclopedia Entry for Methemoglobinemia :Methemoglobinemia - acquired. Acquired methemoglobinemia results from exposure to certain drugs, chemicals, or foods. The condition may also be passed down through families (inherited).Blood cells Blood cells.Benz EJ, Ebert BL. Hemoglobin variants associated with hemolytic anemia, altered oxygen affinity, and methemoglobinemias.Encyclopedia Entry for Methemoglobinemia :Methemoglobinemia. MetHb condition can be: Passed down through families (inherited or congenital) Caused by exposure to certain medicines, chemicals, or foods (acquired) There are two forms of inherited MetHb. The first form is passed on by both parents. The parents usually do not have the condition themselves. They carry the gene that causes the condition. It occurs when there is a problem with an enzyme called cytochrome b5 reductase. There are two types of inherited MetHb: Type 1 (also called erythrocyte reductase deficiency) occurs when RBCs lack the enzyme. Type 2 (also called generalized reductase deficiency) occurs when the enzyme doesn't work in the body. The second form of inherited MetHb is called hemoglobin M disease. It is caused by defects in the hemoglobin protein itself. Only one parent needs to pass on the abnormal gene for the child to inherit the disease. Acquired MetHb is more common than the inherited forms. It occurs in some people after they are exposed to certain chemicals and medicines, including: Anesthetics such as benzocaine Nitrobenzene Certain antibiotics (including dapsone and chloroquine) Nitrites (used as additives to prevent meat from spoiling).Symptoms of type 1 MetHb include: Bluish coloring of the skin Symptoms of type 2 MetHb include: Developmental delay Failure to thrive Intellectual disability Seizures Symptoms of hemoglobin M disease include: Bluish coloring of the skin Symptoms of acquired MetHb include: Bluish coloring of the skin Headache Giddiness Altered mental state Fatigue Shortness of breath Lack of energy.A baby with this condition will have a bluish skin color (cyanosis) at birth or shortly afterward. The health care provider will perform blood tests to diagnose the condition. Tests may include: Checking the oxygen level in the blood (pulse oximetry) Blood test to check levels of gases in the blood ( arterial blood gas analysis ).People with hemoglobin M disease don't have symptoms. So, they may not need treatment. A medicine called methylene blue is used to treat severe MetHb. Methylene blue may be unsafe in people who have or may be at risk for a blood disease called G6PD deficiency. They should not take this medicine. If you or your child has G6PD deficiency, always tell your provider before getting treatment. Ascorbic acid may also be used to reduce the level of methemoglobin. Alternative treatments include hyperbaric oxygen therapy , red blood cell transfusion and exchange transfusions. In most cases of mild acquired MetHb, no treatment is needed. But you should avoid the medicine or chemical that caused the problem. Severe cases may need a blood transfusion.People with type 1 MetHb and hemoglobin M disease often do well. Type 2 MetHb is more serious. It often causes death within the first few years of life. People with acquired MetHb often do very well once the medicine, food, or chemical that caused the problem is identified and avoided.Complications of MetHb include: Shock Seizures Death.Call your provider if you: Have a family history of MetHb Develop symptoms of this disorder Call your provider or emergency services (911) right away if you have severe shortness of breath.Genetic counseling is suggested for couples with a family history of MetHb and are considering having children. Babies 6 months or younger are more likely to develop methemoglobinemia. Therefore, homemade baby food purees made from vegetables containing high levels of natural nitrates, such as carrots, beetroots, or spinach should be avoided.Hemoglobin M disease; Erythrocyte reductase deficiency; Generalized reductase deficiency; MetHb.Blood cells Blood cells.Benz EJ, Ebert BL. Hemoglobin variants associated with hemolytic anemia, altered oxygen affinity, and methemoglobinemias.