{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:58:22Z","timestamp":1785473902712,"version":"3.56.0"},"reference-count":12,"publisher":"SAABRON PRESS","issue":"3","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec id=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Congenital methemoglobinemia is a rare inherited disorder caused by impaired reduction of methemoglobin to functional hemoglobin, resulting in functional hypoxia despite normal arterial oxygen tension. Due to its often-mild clinical phenotype, diagnosis is frequently delayed or made incidentally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective case series of surgical patients was conducted at a tertiary care center in South India over a one-year period. Patients incidentally diagnosed with methemoglobinemia during perioperative or acute medical evaluation were included. Diagnosis was established using arterial blood gas analysis with co-oximetry and confirmed biochemically by erythrocyte NADH\u2013cytochrome b5 reductase activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ten surgical patients were identified, all originating from a single geographic region. Methemoglobin levels ranged from 14.4% to 29.1%. Most patients were asymptomatic or mildly symptomatic, with diagnosis prompted by refractory hypoxemia and a characteristic saturation gap. Enzyme assays confirmed Type I congenital methemoglobinemia in all cases. Management was largely supportive, with methylene blue reserved for symptomatic individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case series highlights incidental perioperative detection as a key diagnostic opportunity and suggests possible regional clustering of congenital methemoglobinemia. Increased clinical awareness and targeted screening may improve the diagnosis of this underrecognized condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.46989\/001c.164967","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:10:46Z","timestamp":1785471046000},"source":"Crossref","is-referenced-by-count":0,"title":["Incidental perioperative detection of congenital methemoglobinemia: A prospective case series from a South Indian referral centre"],"prefix":"10.46989","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7758-1092","authenticated-orcid":true,"given":"Pooja","family":"Pushparaj","sequence":"first","affiliation":[{"name":"Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3885-7822","authenticated-orcid":false,"given":"Aboobacker","family":"Mohamed Rafi","sequence":"additional","affiliation":[{"name":"Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"26435","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"issue":"1","key":"ref1","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1111\/cge.12326","article-title":"Clinical spectrum and molecular basis of recessive congenital methemoglobinemia in India","volume":"87","author":"P. P. Warang","year":"2015","journal-title":"Clin Genet"},{"key":"ref2","article-title":"Methemoglobinemia Continuing Education Activity","author":"A. J. Richard Chen","year":"2025"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2025.1563277","article-title":"Case Report: Clinical presentations of cyanosis associated with acquired methemoglobinemia in infants\u2014a clinical challenge","volume":"13","author":"L. Wang","year":"2025","journal-title":"Front Pediatr"},{"issue":"12","key":"ref4","doi-asserted-by":"publisher","first-page":"1666","DOI":"10.1002\/ajh.26340","article-title":"Recommendations for diagnosis and treatment of methemoglobinemia","volume":"96","author":"A. Iolascon","year":"2021","journal-title":"Am J Hematol"},{"issue":"9","key":"ref5","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1001\/jamainternmed.2013.75","article-title":"Risk of Topical Anesthetic\u2013Induced Methemoglobinemia","volume":"173","author":"S. Chowdhary","year":"2013","journal-title":"JAMA Intern Med"},{"issue":"5","key":"ref6","doi-asserted-by":"publisher","first-page":"471","DOI":"10.17245\/jdapm.2021.21.5.471","article-title":"Anesthetic experience: congenital methemoglobinemia due to hemoglobin M","volume":"21","author":"H. Ri","year":"2021","journal-title":"J Dent Anesth Pain Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"E660","DOI":"10.1097\/HS9.0000000000000660","article-title":"Summary of Joint European Hematology Association (EHA) and EuroBloodNet Recommendations on Diagnosis and Treatment of Methemoglobinemia","volume":"5","author":"A. Iolascon","year":"2021","journal-title":"HemaSphere"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.58312","article-title":"Shades of Blue: A Case Series of Acquired Methemoglobinemia","author":"B. D. Rathod","year":"2024","journal-title":"Cureus"},{"issue":"3","key":"ref9","doi-asserted-by":"publisher","first-page":"615","DOI":"10.3390\/medicina59030615","article-title":"Hereditary Congenital Methemoglobinemia Diagnosed at the Age of 79 Years: A Case Report","volume":"59","author":"M. Nakata","year":"2023","journal-title":"Medicina (B Aires)"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.20471\/acc.2022.61.s1.16","article-title":"Methemoglobinemia \u2013 a Case Report and Literature Review","author":"I. Ivek","year":"2022","journal-title":"Acta Clin Croat"},{"issue":"1","key":"ref11","doi-asserted-by":"publisher","first-page":"128","DOI":"10.4103\/ajts.ajts_152_20","article-title":"Successful management of Methemoglobinemia and G6PD deficiency in a patient posted for surgical excision of branchial cyst","volume":"16","author":"V. J. Arun","year":"2022","journal-title":"Asian J Transfus Sci"},{"issue":"5","key":"ref12","doi-asserted-by":"publisher","first-page":"1714","DOI":"10.1007\/s12325-020-01282-5","article-title":"Methemoglobinemia in the Operating Room and Intensive Care Unit: Early Recognition, Pathophysiology, and Management","volume":"37","author":"J. N. Cefalu","year":"2020","journal-title":"Adv Ther"}],"container-title":["Clinical Hematology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/chi.scholasticahq.com\/article\/164967-incidental-perioperative-detection-of-congenital-methemoglobinemia-a-prospective-case-series-from-a-south-indian-referral-centre","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:10:47Z","timestamp":1785471047000},"score":1,"resource":{"primary":{"URL":"https:\/\/chi.scholasticahq.com\/article\/164967-incidental-perioperative-detection-of-congenital-methemoglobinemia-a-prospective-case-series-from-a-south-indian-referral-centre"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":12,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.46989\/001c.164967","relation":{},"ISSN":["2590-0048"],"issn-type":[{"value":"2590-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]}}}