A 25-year-old American woman went to the emergency room with discoloured skin — she was literally turning blue.
According to a case report published in the New England Journal of Medicine, the woman had been experiencing weakness, fatigue, shortness of breath and skin discolouration for a day before visiting the emergency room.
“I’m weak and I’m blue,” NBC News reported she told emergency room doctors.
She was also breathing a little fast, and even when given oxygen, the oxygen level in her blood wasn’t improving.
When doctors took blood samples, they discovered something shocking: her blood had turned a dark, inky blue.
They diagnosed the woman with methemoglobinemia: a condition where the blood contains too much methemoglobin, a form of hemoglobin – the protein that carries oxygen to the body. Methemoglobin isn’t able to release oxygen to the body’s tissues very well, according to a 2001 paper on the condition.
This lack of oxygen leads to headaches, lethargy, weakness and dizziness, as well as blue skin, according to a review in the Israel Medical Association Journal. The blood of affected patients often appears dark brown, or in this case, blue.
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Some people are genetically predisposed to methemoglobinemia, but most cases are as a result of medication, like some anesthetics.
In this case, the woman had been using “large amounts” of topical benzocaine to treat a toothache the night before developing symptoms.
She was treated — maybe ironically — with a medication called methylene blue and her symptoms resolved completely. She was sent home with a referral to go see a dentist.
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