Extreme but asymptomatic carboxyhemoglobinemia and chronic lung disease

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Abstract
Carboxyhemoglobinemia is a well-known consequence of CO exposure from smoking. Only moderately elevated levels have been reported. The case of an asymptomatic man with severe chronic obstructive lung disease and HbCO levels repeatedly in excess of 30% (maximum, 38.0%) due to smoking is reported. The mechanism by which such high levels were attained was primarily a combination of arterial hypoxia and a high CO yield from tobacco. For a given level of CO exposure, the hypoxic person will attain a higher HbCO level than will a person without hypoxia.

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