Low oxygen saturation and discordant arterial blood gas measures have diagnosed a case of hemoglobinopathy
https://doi.org/10.18093/0869-0189-2024-4386
Abstract
Pulse oximeter is a simple non-invasive equipment used to determine patient’s arterial blood oxygen saturation (SpO2). However, in some people, arterial blood gas measures (SaO2) are normal and low SpO2 values are related to hemoglobin variant rather than cardiac or pulmonary illnesses.
Aim. We present a case of thalassemia that manifested with low SpO2 and discordant SaO2.
Conclusion. When examining a patient with an unusually low SpO2, the differential diagnosis of a suspected hemoglobin variant should be investigated. Establishing an accurate diagnosis as soon as possible may help avoid unnecessary tests.
Supporting agencies: No financial support was provided
About the Authors
H. W. Abdelwahab
Mansoura University Hospitals
Egypt
Competing Interests:
Egypt
Abdelwahab Heba Wagih - MD, Assistant Professor of Chest Medicine.
El Gomhouria St. 60, Dakahlia Governorate, 35516, Mansoura City; tel.: (0020100) 067-03-65
Competing Interests:
Authors declare no conflict of interest
Kh. M. Elsherbiny
Mansoura University Hospitals
Egypt
Competing Interests:
Egypt
Elsherbiny Khalid Mohammed - Assistant Lecturer of Chest Medicine.
El Gomhouria St. 60, Dakahlia Governorate, 35516, Mansoura City
Competing Interests:
Authors declare no conflict of interest
M. M. Rezkalla
Mansoura University Hospitals
Egypt
Competing Interests:
Egypt
Rezkalla Marina Mahfouz - Assistant Lecturer of Cardiology.
El Gomhouria St. 60, Dakahlia Governorate, 35516, Mansoura City
Competing Interests:
Authors declare no conflict of interest
T. Awad
Mansoura University Hospitals
Egypt
Competing Interests:
Egypt
Awad Tamer - Lecturer of Chest Medicine.
El Gomhouria St. 60, Dakahlia Governorate, 35516, Mansoura City
Competing Interests:
Authors declare no conflict of interest
A. Adel
Mansoura University Hospitals
Egypt
Competing Interests:
Egypt
Adel Asmaa - Assistant Lecturer of Chest Medicine.
El Gomhouria St. 60, Dakahlia Governorate, 35516, Mansoura City
Competing Interests:
Authors declare no conflict of interest
A. Hweidy
Mansoura University Hospitals
Egypt
Competing Interests:
Egypt
Hweidy Asem - Professor Lecturer of Chest Medicine.
El Gomhouria St. 60, Dakahlia Governorate, 35516, Mansoura City
Competing Interests:
Authors declare no conflict of interest
References
1. Verhovsek M., Henderson M.P., Cox G. et al. Unexpectedly low pulse oximetry measurements associated with variant hemoglobins: a systematic review. Am. J. Hematol. 2010; 85 (11): 882–885. DOI: 10.1002/ajh.21810.
2. Hladik A., Lynshue K. Dyshemoglobinemias and pulse oximetry: a therapeutic challenge. J. Pediatr. Hematol. Oncol. 2008; 30 (11): 850–852. DOI: 10.1097/MPH.0b013e31817e4a19.
3. Hardison R.C., Chui D.H., Giardine B. et al. HbVar: A relational database of human hemoglobin variants and thalassemia mutations at the globin gene server. Hum. Mutat. 2002; 19 (3): 225–233. DOI: 10.1002/humu.10044.
4. Perkins G.D., McAuley D.F., Giles S. et al. Do changes in pulse oximeter oxygen saturation predict equivalent changes in arterial oxygen saturation? Crit. Care. 2003; 7 (4): R67. DOI: 10.1186/cc2339.
5. Pritišanac E., Urlesberger B., Schwaberger B., Pichler G. Accuracy of pulse oximetry in the presence of fetal hemoglobin-a systematic review. Children (Basel). 2021; 8 (5): 361. DOI: 10.3390/children8050361.
6. Holbrook S.P.,Quinn A. An unusual explanation for low oxygen saturation. Br. J. Anaesth. 2008; 101 (3): 350–353. DOI: 10.1093/bja/aen183.
7. Zur B., Bagci S., Ludwig M., Stoffel-Wagner B. Oxygen saturation in pulse oximetry in hemoglobin anomalies. Klin. Padiatr. 2012; 224 (4): 259–265. DOI: 10.1055/s-0032-1312612.
8. Deyell R., Jackson S., Spier S. et al. Low oxygen saturation by pulse oximetry may be associated with a low oxygen affinity hemoglobin variant, hemoglobin Titusville. J. Pediatr. Hematol. Oncol. 2006; 28 (2): 100–102. DOI: 10.1097/01.mph.0000200685.33291.0a.
9. Abdulmalik O., Safo M.K., Lerner N.B. et al. Characterization of hemoglobin bassett (alpha94Asp-->Ala), a variant with very low oxygen affinity. Am. J. Hematol. 2004; 77 (3): 268–276. DOI: 10.1002/ajh.20184.
10. Jennis M.S., Peabody J.L. Pulse oximetry: An alternative method for the assessment of oxygenation in newborn infants. J. Pediatr. 1987; 79 (4): 524–528. DOI: 10.1542/peds.79.4.524.
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For citations:
Abdelwahab H.W., Elsherbiny Kh.M., Rezkalla M.M., Awad T., Adel A., Hweidy A. Low oxygen saturation and discordant arterial blood gas measures have diagnosed a case of hemoglobinopathy. PULMONOLOGIYA. 2024;34(6):930-932. https://doi.org/10.18093/0869-0189-2024-4386
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