Sulfhemoglobinemia

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Abstract
SULFHEMOGLOBIN, methemoglobin, and the M hemoglobins must be considered when one is evaluating the cyanotic patient. Sulfhemoglobin is a green-pigmented molecule with a sulfur atom incorporated into the porphyrin ring and a markedly reduced oxygen affinity that makes it ineffective for oxygen transport. It has been associated with drug abuse,1 2 3 4 5 6 7 occupational exposure to sulfur compounds,8 , 9 and recently, environmental exposure to polluted air.10 In sulfhemoglobinemia, methemoglobinemia, and the presence of M hemoglobins in the blood, cyanosis is not itself a sign of respiratory insufficiency. Rather, the slate-gray skin color is the result of the spectral characteristics of the abnormal pigments. The . . .