Page 18 - JSOM Fall 2019
P. 18
Disclaimer
GLOSSARY OF KEY TERMS The views expressed in this article are those of the authors and
do not reflect the official policy or position of the US Army or
Co-oximetry. Blood test that reports percentages of various Department of Defense.
forms of hemoglobin including hemoglobin bound to carbon
monoxide (carboxyhemoglobin) and hemoglobin containing Author Contributions
ferric iron (methemoglobin). All authors were directly involved in the clinical care and di-
agnosis of this patient. RE conducted a review of relevant lit-
Cytochrome b5 reductase. Also known as NADH- erature and wrote the initial draft, and all authors edited and
cytochrome b5 reductase 3, a soluble enzyme found in red approved the final manuscript.
blood cells that protects the cell from oxidative stress by re-
ducing methemoglobin (containing ferric iron) to normal he- Disclosure
moglobin (containing ferrous iron). The authors have indicated that they have no financial rela-
Force Health Protection Plan. “All measures taken by com- tionships relevant to this article to disclose.
manders, supervisors, individual Servicemembers, and the
MHS to promote, protect, improve, conserve, and restore the References
mental and physical well-being of Servicemembers across the 1. AFHSB. Update: Malaria, U.S. Armed Forces, 2017. MSMR.
2018;25(2):2–7.
full range of military activities and operations.” 15 2. Tafenoquine [package insert]. Washington, DC: Sixty Degrees
Glucose-6-phosphatase dehydrogenase. An enzyme found Pharmaceuticals; 2018.
in red blood cells essential to protecting against oxidation and 3. CDC. CDC Yellow Book 2018. New York, NY: Oxford Univer-
sity Press; 2017.
hemolysis through the regeneration of the molecule NADPH 4. Cockrill JA, et al. Optimizing preventive strategies and malaria
and reduction of glutathione stores. diagnostics to reduce the impact of malaria on US military forces.
DOD Malaria Stakeholder Meeting; 30–31 May 2012; AFHSC.
Hemolytic anemia. An abnormally low hemoglobin levels and http://www.dtic.mil/dtic/tr/fulltext/u2/a582621.pdf. Accessed June
thus oxygen carrying capacity due to destruction of red blood 25, 2018.
cells. 5. Cohen RJ, Sachs JR, Wicker DJ, et al. Methemoglobinemia pro-
voked by malarial chemoprophylaxis in Vietnam. N Engl J Med.
Hemoglobin electrophoresis. Blood test that can identify 1968;279(21):1127–1131.
variations of the hemoglobin protein including normal vari- 6. Kantor GS. Primaquine-induced methemoglobinemia during
ants and abnormal types such as those found in sickle cell dis- treatment of Pneumocystis carinii pneumonia. N Engl J Med.
ease or thalassemia. 1992;327:1461.
7. Hamill M, Harte D, Miller RF. Methaemoglobinaemia causing
Hemolysis. The destruction (rupture) of red blood cells. progressive dypsnoea and cyanosis during treatment of Pneumo-
cystis jirovecii pneumonia. Int J STD AIDS. 2007;18(8):577–578.
Heterozygous. An individual with two distinct alleles for a 8. Safrin S, Finkelstein DM, Feinberg J, et al. Comparison of three
given gene. regimens for treatment of mild to moderate pneumocystis carinii
pneumonia in patients. Ann Internal Med. 1996;124(9):792–802.
Hypnozoite. A dormant form in a parasitic life cycle that can 9. Ray P, Birolleau S, Lefort Y, et al. Acute respiratory failure in the
persist in human liver and cause delayed infection. elderly: etiology, emergency diagnosis and prognosis. Crit Care.
Presumptive antirelapse therapy (PART). Medication taken 2006;10(3):R82.
following prolonged exposure in malaria-endemic areas to 10. Vieira JL, Ferreira MES, Ferreira MVD, et al. Primaquine in
plasma and methemoglobinemia in patient with malaria due to
prevent delayed-onset infection caused by the dormant liver Plasmodium vivax in the Brazilian Amazon Basin. Am J Trop
stage of specific malaria strains (Plasmodium vivax, Plasmo- Med Hyg. 2017;96(5):1171–1175.
dium ovale). 11. Ferreira ME, Gomes MS, Vieira JL. [Methemoglobinemia in
patients with Plasmodium vivax receiving oral therapy with pri-
Primaquine. An antimalarial medication used to eliminate dor- maquine]. Rev Soc Bras Med Trop. 2011;44(1):113–115.
mant hypnozoites of Plasmodium vivax and Plasmodium ovale. 12. Baird JK, Lacy MD, Basri H, et al. Randomized, parallel pla-
cebo-controlled trial of primaquine for malaria prophylaxis in
Papua, Indonesia. Clin Infect Dis. 2001;33(12):1990–1997.
Epub 2001 Nov 12.
13. Carmona-Fonseca J, Alvarez G, Maestre A. Methemoglobinemia
and adverse events in Plasmodium vivax malaria patients associ-
ated with high doses of primaquine treatment. Am J Trop Med
Hyg. 2009;80(2):188–193.
14. Prchal JT. Genetics and pathogenesis of congenital and acute
toxic methemoglobinemia. UpToDate. Published May 2018. Up-
dated 23 May 2018. Accessed 25 Jun 2018.
15. Levine P. Force Health Protection Quality Assurance (FHPQA)
Program (DoD Instruction 6200.05). Washington, DC: Depart-
ment of Defense. 21 December 2017. https://www.esd.whs.mil
/Portals/54/Documents/DD/issuances/dodi/620005p.pdf
16 | JSOM Volume 19, Edition 3 / Fall 2019

