Sulfhemoglobinemia

Abstract

SULFHEMOGLOBIN, methemoglobin, and the M hemoglobins must be considered when one is evaluating the cyanotic patient. Sulfhemoglobin is a green-pigmented molecule with a sulfur atom incorporated into the porphyrin ring and a markedly reduced oxygen affinity that makes it ineffective for oxygen transport. It has been associated with drug abuse,^{1 2 3 4 5 6 7} occupational exposure to sulfur compounds,^{8 , 9} and recently, environmental exposure to polluted air.¹⁰ In sulfhemoglobinemia, methemoglobinemia, and the presence of M hemoglobins in the blood, cyanosis is not itself a sign of respiratory insufficiency. Rather, the slate-gray skin color is the result of the spectral characteristics of the abnormal pigments. The . . .