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Hemoglobin derivatives

Methemoglobin; Carboxyhemoglobin; Sulfhemoglobin

Hemoglobin derivatives are altered forms of hemoglobin. Hemoglobin is a protein in red blood cells that moves oxygen and carbon dioxide between the lungs and body tissues.

This article discusses the test used to detect and measure the amount of hemoglobin derivatives in your blood.

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Blood test

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How the Test is Performed

The test is done using a small needle to collect a sample of blood from a vein or an artery. The sample may be collected from a vein or artery in the wrist, groin, or arm.

Before blood is drawn, the health care provider may test circulation to the hand (if the wrist is the site). After the blood is drawn, pressure applied to the puncture site for a few minutes stops the bleeding.

How to Prepare for the Test

No special preparation is needed.

For children, it may help to explain how the test will feel and why it is done. This may make the child feel less nervous.

How the Test will Feel

You may feel slight pain or a sting when the needle is inserted. You may also feel some throbbing at the site after the blood is drawn.

Why the Test is Performed

The carboxyhemoglobin test is used to diagnose carbon monoxide poisoning. It is also used to detect changes in hemoglobin that may result from certain drugs. Some chemicals or drugs can change the hemoglobin so it no longer works properly.

Abnormal forms of hemoglobin include:

Normal Results

The following values represent the percentage of hemoglobin derivatives based on total hemoglobin:

Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What Abnormal Results Mean

High levels of hemoglobin derivatives can lead to major health problems. The altered forms of hemoglobin do not allow oxygen to be moved properly through the body. This can lead to tissue death.

The following values, except sulfhemoglobin, represent the percentage of hemoglobin derivatives based on total hemoglobin.

Carboxyhemoglobin:

Methemoglobin:

Sulfhemoglobin:

Related Information

Hemoglobin
Carbon monoxide poisoning
Cytochrome b5 reductase
Blue discoloration of the skin
Fatigue
Decreased alertness

References

Benz EJ, Ebert BL. Hemoglobin variants associated with hemolytic anemia, altered oxygen affinity, and methemoglobinemias. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 43.

Bunn HF. Approach to the anemias. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 158.

Christiani DC. Physical and chemical injuries of the lung. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 94.

Nelson LS, Ford MD. Acute poisoning. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 110.

Vajpayee N, Graham SS, Bem S. Basic examination of blood and bone marrow. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO: Elsevier; 2017:chap 30.

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Review Date: 4/26/2019  

Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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