• Desirée Verde Lopes, Lazar NetoFelippeFDepartment of Internal Medicine, Hospital Dr. Moyses Deustche (Mboi Mirim), Estrada do Mboi Mirim, 5203, São Paulo, Brazil.Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av. Dr. Enéas Carvalh, Lais C Marques, Rodrigo B O Lima, and Antonio Adolfo Guerra Soares Brandão.
• Department of Internal Medicine, Hospital Dr. Moyses Deustche (Mboi Mirim), Estrada do Mboi Mirim, 5203, São Paulo, Brazil.
• IDCases. 2021 Jan 1; 23: e01013.

AbstractWe report a second case of methemoglobinemia and non-autoimmune hemolytic anemia after contracting the SARS-CoV-2 infection in the absence of an identifiable eliciting drug. A 35-year old male without previous known comorbidities was admitted after he was diagnosed with the COVID-19 infection and had large pulmonary involvement. Seven days later, he desaturated but was without any signs of respiratory distress. A check of arterial blood gas revealed normal partial pressure of oxygen and follow-up tests confirmed a methemoglobinemia diagnosis. Over the next few days, hemolysis was established after decreased levels of hemoglobin and increased levels of indirect bilirubin and lactate dehydrogenase. A hemolytic anemia investigation panel came back normal, including G6PD. A second G6PD test was ordered at the 5-month follow-up appointment and revealed decreased levels. Clinicians should thus be aware of possible false negative tests when testing for G6PD during hemolytic crisis. In addition, whether the COVID-19 infection alone would be responsible for this chain of events remains a challenging question.© 2020 The Authors.

5 keywords...

hide…