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Pictures of people infected with the disease would be a nice addition. Maybe just their hands. Randomfrenchie 01:10, 9 February 2007 (UTC)

here is a picture that might work: Patient with Chemical-Induced Methemoglobinemia 1:31, 31 March 2007 —The preceding unsigned comment was added by (talk) 05:31, 31 March 2007 (UTC).

groundwater nitrate[edit]

"It can be caused by drinking water nitrate-nitrogen levels that exceed current EPA standards of 10ppm. Nitrate can cause the reaction in the bloodstream, especially in babies."

Actually Methemoglobinemia is caused by drinking water with elevated nitrite-nitrogen levels. Levels of nitrite associated with the reaction have not been documented - levels are transitory. The EPA nitrate criteria is a proxy for dealing with the nitrite concern. Nursing babies are particularly sensitive because their ability to metabolise nitrite is undeveloped. Young children are capable of digesting large quantities of nitrites. The sales of lunch meat and hot dogs relies heavily on this metabolic capacity.- Paleorthid 17:52, 24 January 2006 (UTC)

Changed. -- Irixman (t) (m) 23:36, 4 June 2006 (UTC)
I have found a more informative reference that indicates my previous understanding, as stated above, was simpplistic. Nitrates in water are a problem (in addition to the nitrites) for infants because they metabolize nitrates into nitrites. -- 01:24, 5 June 2006 (UTC)

The Fugates of Kentucky/West Virginia do not have methemoglobinemia from drinking water, it is a recessive gene carried down in the family. Both parents must carry this gene in order to produce a "blue" child. I know this because I have Fugates in my family lineage and have done research on this family line. There are at least eight generations in my family between the Fugate line and the Ritchie line that have "blue" skin and fingernails. ~~FloraCalifornia

Congenital Methemoglobinemia[edit]

Official enzyme name: NADH-cytochrome b5 reductase, symbol: CYB5R3 (link to: The name Diaphorase was used previously, but it is not consider the official name anymore. —Preceding unsigned comment added by (talk) 14:40, 15 December 2009 (UTC)

Appalachian Blue People (merger debate)[edit]

Suggested addition: A very well-known series of cases was among the Moon Family of Eastern Kentucky/Western Virginia area. It carried on through several generations, due to a high amount of intermarriage in the area. This might be an informative addition to the article

Added, but I saw it was among the Fugate family, per my cited reference. -- Irixman (t) (m) 23:36, 4 June 2006 (UTC)

I disagree. Do not merge this entry with the entry on the Blue Fugates of Appalachia - continue to provide links and cross-references between the two articles. The Blue Fugate entry has the potential to be expanded as a family history, with many details outside the scope of a general overview of methemoglobinemia. See FloraCalifornia's note above for an example. If more information about the Fugate family is posted to Wikipedia, it would simply clutter up a combined entry, and result in the entries being split apart anyway. -- 04:30, 23 November 2006 (UTC)
I googled 'Blue Fugates' hoping *specifically* to find a Wikipedia entry on them. Since I wrote the above^^^ comment, you have removed all but the most basic information about the Blue Fugates - now there is NO room for the type of biographical information I was looking for, and the Fugates are reduced to a one-paragraph example of symptoms. Can you please explain this decision? -- 19:37, 25 November 2006 (UTC)
I reverted Blue Fugates back to its state before redirect. I couldn't find any record of this merger reaching consensus--the only comments on it seem to be the ones above, which go against it. (I'd second that vote). Torc2 23:09, 5 October 2007 (UTC)
I am for a merge because the Methemoglobinemia article has all of the information that this article has. As for the argument that the addition of more information about the blue fugates would clutter the methemoglobinemia article... no content additions have been made to the blue fugates article since its december 2005 creation... almost two years ago. I seriously doubt a content addition is coming. Also, a number of merger attempts have been made and reverted (including my own), demonstrating that support exists for a merger even if not in the form of 'offical' votes on the discussion page. --Nanobri 01:53, 8 October 2007 (UTC)

Let's please close the debate on this page and discuss it from scratch over here (as is normal procedure according to Wikipedia:Merging_and_moving_pages#Proposing_a_merger. Torc2 04:37, 14 October 2007 (UTC)


I am unsure exactly what the percentages indicates. 70% of people exposed to the LD-50 of any nitrite die? It takes 70% over a normal dose to kill someone? Etc... please readd if anyone knows what they truly indicate, and explain a ibit. -- Irixman (t) (m) 23:36, 4 June 2006 (UTC)

Currently, the article reads:

Signs and symptoms of methemoglobinemia (methemoglobin >1%) include shortness of breath, cyanosis, mental status changes, headache, fatigue, exercise intolerance, dizziness and loss of consciousness. Arterial blood with elevated methemoglobin levels has a characteristic chocolate-brown color as compared to normal bright red oxygen containing arterial blood. Severe methemoglobinemia (methemoglobin >50%) patients have dysrhythmias, seizures, coma and death. Healthy people may not have many symptoms with methemoglobin levels < 15%, however patients with co-morbidities such as anemia, cardiovascular disease, lung disease, sepsis, or presence of other abnormal hemoglobin species (e.g. carboxyhemoglobin, sulfehemoglobin or sickle hemoglobin) may experience moderate to severe symptoms at much lower levels (as low as 5-8%).

Is there any source or justification for this? The Fugates obviously were not only free from these effects, but lived to extreme old age (80s, 90s) and exhibited pronounced fertility (10+ surviving children) in relatively primitive conditions (turn-of-the-century rural Appalachia) where one would expect shorter-than-average lifespans and increased infant mortality. -LlywelynII (talk) 14:51, 13 September 2008 (UTC)
  • Yes, there are plenty of sources for the side effects of methemoglobinemia. I added an eMedicine reference to back up the facts. All the eMedicine articles discuss the negative consequences of metHG. It is a potentially lethal condition if severe enough. Mechanistically, it leads to hemoglobin that cannot carry oxygen because of oxidization of the iron to Ferric from Ferrous. There's no arguing with the concept that hypoxemia can cause death. It's akin to asphyxiation. I can't comment on the Fugates because I don't know anything about the situation, and cannot find anything that would denote their metHG levels. Note that emerg/313 states that cyanosis, turning blue, is present anywhere between 3-15% metHG and the condition can be asymptomatic up to 20% metHG. It is likely that the Fugates were within this range. In general however, there is no doubt that high metHG levels can have serious health sequelae. Chaldor (talk) 20:01, 13 September 2008 (UTC)


How do you say this word? [mɛˌti.məˌglo(ʊ).bəˈni.mi.ə] or [mɛˌθi.məˌglo(ʊ).bəˈni.mi.ə]? -- Denelson83 04:27, 5 April 2007 (UTC)

  • It's the first one. Chaldor (talk) 19:30, 13 September 2008 (UTC)

Merged content from Blue Fugates[edit]

Kville105125 03:20, 14 October 2007 (UTC) See old talk page Talk:Blue Fugates

Why? There hasn't been consensus yet, has there? Torc2 04:17, 14 October 2007 (UTC)

Please see here (as is normal procedure according to Wikipedia:Merging_and_moving_pages#Proposing_a_merger. Torc2 04:37, 14 October 2007 (UTC)

Removal of probable copyvio material[edit]

This series edits by an anon IP editor on 21 August would seem to be a copyvio, given the use from nowhere of numbered footnotes (the article does not use the cite.php system, and certainly not from number 24). As such I have removed the material on sight, (as shown below):

It has been reported (Heard & Ashworth 1968 apud Basrani et al. 2007) that, when placed in an aqueous solution, Chlorhexidine Gluconate (antiseptic) slowly hydrolyzes and forms para-chloroaniline (4-Chloroaniline, p-Chloroaniline or PCA) (24). Para-chloroaniline (PCA) has been shown to be toxic (28, 29). As an aromatic amine, the primary toxic effect is methemogloblin formation (28). Toxicological studies in rats and mice have shown that the hemopoietc system is the major target for PCA (28). In 1990, Chhabra et al (28) conducted a 90-day study (with p-chloroaniline) and found that methaemoglobin formation and accompanying haemolytic anaemia, extra-medullary haematopoiesis, and splenomegaly were indicative of erythrocyte toxicity and regenerative anemia.

Basrani BR, Manek S, Sodhi RNS, Fillery E, Manzur A. Interaction between sodium hypochlorite and chlorhexidine gluconate. J Endod, 33(8): 966 –969, August, 2007. "doi:10.1016/j.joen.2007.04.001"
24. Heard DD, Ashworth RW. The colloidal properties of chlorhexidine and its integration with some macromolecules. J Pharm Pharmac 1968;20;505–12.
28. Chhabra RS, Huff JE, Haseman JK, Elwell MR, Peters AC. Carcinogenicity of p-chloroaniline in rats and mice. Food Chem Toxicol 1991;29:119 –24.
29. Burkhardt-Holm P, Oulmi Y, Schroeder A, Storch V, Braunbeck T. Toxicity of 4-chloraniline in early life stages of Zebrafish (Danio rerio): II. Cytopathology and regeneration of liver and gills after prolonged exposure to waterborne 4 chloraniline. Arch Environ Contam Toxicol 1999;37:85–102.
30. Hazardous Substances Data Bank (HSDB). A database of the National Library of Medicines TOXNET System, http://toxnet.; last accessed Feb 2007.

Could editors with knowledge of the topic consider if the points that the paragraph covers are notable, and if so include in a fresh manner. David Ruben Talk 01:27, 23 December 2007 (UTC)

Help citing source on vitamin C[edit]

So, I thought the statement at the end of the Treatment section that said "Also vitamin C cures this condition" seemed kind of dubious. I found vitamine C talked about at and replaced the statement with what it says there. I don't know how to properly reference the website though. Can someone help me? Nanobri (talk) 00:08, 23 February 2008 (UTC)

Punnet Square[edit]

Why not use a Punnett Square instead of the stick people, especially since you have a red person representing the "blue" person? Pnoble805 (talk) 18:08, 13 March 2010 (UTC)


Methemoglobin does not have a higher affinity for oxygen than hemoglobin, it does not carry oxygen at all, hence it's blue colour. —Preceding unsigned comment added by (talk) 20:31, 24 April 2011 (UTC)

Methemoglobin cannot bind O2.[1] --Nsmaloney (talk) 01:53, 9 December 2011 (UTC)nsmaloney

Intro unclear[edit]

The intro doesn't do a very good job of explaining what it is. Especially the sentence: "Methemoglobin is an oxidized form of hemoglobin that has a decreased affinity for oxygen, resulting in an increased affinity of oxygen to other heme sites and overall reduced ability to release oxygen to tissues." It's not clear why this would result in an increased affinity of oxygen elsewhere, and what it means by other heme sites.

CrocodilesAreForWimps (talk) 14:49, 12 March 2012 (UTC)

Yes I agree that the intro needs clarification. Including the "therefore there is an associated left shift" concept, as one may not expect this to be applicable if the active side is irreversibly bound Vokesk (talk) 03:52, 4 March 2015 (UTC)

"The binding of oxygen to methemoglobin results in an increased affinity of oxygen to the three other heme sites (that are still ferrous) within the same tetrameric hemoglobin unit." MetHb is a non-oxygen binding form of Hb. Who's baby is this? Why not just open with "MetHb is hemoglobin where the iron has been oxidised to the trivalent ferric form (Fe3+)" etc... Jgm74 (talk) 14:32, 18 January 2016 (UTC)

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  1. ^ Boron, Walter F. (2009). Medical Physiology: A Cellular and Molecular Approach, second edition. Philadelphia: Saunders. p. 673. ISBN 978-1-4160-3115-4.