title: [Methemalbuminnemia after massive hemolysis during blackwater fever].
abstract: We report a case of blackwater fever with brown plasma due to the presence of methemalbumin. The discovery of plasma with this color is a rare event at the laboratory. This compound appears during intravascular hemolysis or hemorrhagic pancreatitis when the ability of haptoglobin and hemopexin to bind free hemoglobin has been exceeded. In these cases some of heme is oxidized to hematin and taken up by serum albumin to form an albumin-hematin complex called methemalbumin. The major clinical problem is to evoke the diagnosis of methemalbuminemia and not confuse with methemoglobinemia. In our case, methemalbumin was detected and quantified using a scanning spectrophotometer. Its diagnostic and clinicals consequences are discussed.
authors.affiliation: Service de biochimie, toxicologie et pharmacologie cliniques, Hôpital d'instruction des armées Bégin, 94160 Saint Mandé. sgidenne@free.fr
authors.forename: S
authors.initials: S
authors.lastname: Gidenne
authors.forename: F
authors.initials: F
authors.lastname: Ceppa
authors.forename: F
authors.initials: F
authors.lastname: Bruneel
authors.forename: S
authors.initials: S
authors.lastname: Mérat
authors.forename: A
authors.initials: A
authors.lastname: Carde
authors.forename: L
authors.initials: L
authors.lastname: Brinquin
authors.forename: P
authors.initials: P
authors.lastname: Burnat
mesh_terms: D000743:Anemia, Hemolytic / Q000097:blood* / Q000209:etiology*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001742:Blackwater Fever / Q000097:blood* / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D003937:Diagnosis, Differential; D004232:Diuretics / Q000627:therapeutic use; D005665:Furosemide / Q000627:therapeutic use; D006400:Hematocrit; D006418:Heme / Q000378:metabolism; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008705:Methemalbumin / Q000032:analysis / Q000737:chemistry / Q000378:metabolism*; D008875:Middle Aged; D010949:Plasma / Q000737:chemistry; D006435:Renal Dialysis; D012709:Serum Albumin / Q000378:metabolism; D013053:Spectrophotometry; D013256:Steroids; D013921:Thrombocytopenia / Q000145:classification / Q000209:etiology
chemical_list: D000893:Anti-Inflammatory Agents; D004232:Diuretics; D006454:Hemoglobins; D008705:Methemalbumin; D012709:Serum Albumin; D013256:Steroids; D006418:Heme; D005665:Furosemide