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Case Reports
. 2019 Feb 15;12(4):96-98.
doi: 10.1213/XAA.0000000000000855.

Rare Case of Transcutaneous Oxygen Desaturation in a Cancer Patient: A Case Report and Diagnostic Approach for a Recurrent Problem

Kaspar F Bachmann  1 , Mathias Nebiker  2 , Caroline Johner  3 , Rachel Bregy  4 , André Schaller  5 , Urban Novak  6 , Stephan M Jakob  2
Affiliations
Case Reports

Rare Case of Transcutaneous Oxygen Desaturation in a Cancer Patient: A Case Report and Diagnostic Approach for a Recurrent Problem

Kaspar F Bachmann et al. A A Pract. .

Abstract

We present a case of a 73-year-old cancer patient with low transcutaneous oxygen saturation who was transferred to the intensive care unit after deployment of the rapid response team. Differential diagnosis remained broad until methemoglobinemia (MetHb) was detected.MetHb was induced by administration of rasburicase, which was given to prevent tumor lysis syndrome. In a follow-up examination, glucose-6-phosphate dehydrogenase deficiency was found to be the cause of MetHb after rasburicase exposure.Diagnosis was made by either measuring arterial MetHb or CO oximeter. Treatment options involve transfusion and methylene blue, if glucose-6-phosphate dehydrogenase deficiency is not present.

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