{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:11:49Z","timestamp":1789193509703,"version":"build-2803163510"},"reference-count":71,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Methaemoglobin (MetHb) is an oxidised form of haemoglobin (Hb) unable to bind oxygen. Raised levels of MetHb reduce the blood's oxygen\u2010carrying capacity, causing potentially severe hypoxaemia and possible death. The condition arises from three main pathologies: mutations in globin genes causing Haemoglobin\u2010M, inherited deficiency of the enzyme cytochrome b5 reductase (CytB5R) responsible for reducing MetHb back into functional Hb, and exposure to some oxidising agents. Well\u2010documented causative agents include dapsone and cocaine\u2010derived anaesthetics, with emerging evidence highlighting an increasing contribution from recreational and non\u2010prescribed exposures. As the concentration of MetHb level increases, the oxygen\u2010carrying capacity of the blood decreases. MetHb levels are usually measured by co\u2010oximetry. Patients are typically asymptomatic at MetHb concentrations &lt;10% with symptoms developing as levels increase, including cyanosis, confusion, arrhythmias, coma and death. These features will present alongside misleadingly normal partial pressure of oxygen in arterial blood and arterial oxygen saturation values on arterial blood gas and will not improve with supplemental oxygen. Management depends on severity, with intravenous methylene blue remaining first\u2010line treatment for symptomatic cases. Alternative therapies include high\u2010dose vitamin C, exchange transfusion and potentially hyperbaric oxygen, although there is little evidence to suggest how these should be used. Due to the potentially confusing acute presentation of the condition, the diagnosis can easily be missed.<\/jats:p>","DOI":"10.1111\/bjh.70647","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T12:54:47Z","timestamp":1782910487000},"page":"900-910","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Methaemoglobinaemia: From pathophysiology to contemporary clinical management"],"prefix":"10.1111","volume":"209","author":[{"given":"Alexander J.","family":"Twine","sequence":"first","affiliation":[{"name":"Faculty of Life Sciences &amp; Medicine King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Rees","sequence":"additional","affiliation":[{"name":"School of Cancer and Pharmaceutical Sciences, Faculty of Life Sciences and Medicine King's College Hospital  London 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