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Hemoglobin Lansing as a Cause of Spurious Low Oxygen Saturation on Pulse Oximetry in a Neonate

Sariya Prachukthum MD*, Wallee Satayasai MD*, Pacharapan Surapolchai MD*, Phakatip Sinlapamongkolkul MD*, Vip Viprakasit MD**

Affiliation : * Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand ** Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

A pulse oximeter is an easy, painless and non-invasive device to measure blood oxygen saturation (SpO2). Usually, SpO2 is comparable to oxygen saturation by arterial blood gas (SaO2). We report a case of term infant presented with respiratory distress and low oxygen saturation measuring with a pulse oximeter. Respiratory disease and congenital heart disease were excluded. Discordance of oxygen saturation was presented. His blood was obtained to check methemoglobin level and hemoglobin (Hb) variants. Hb Lansing was detected. In addition to report the first neonate with Hb Lansing in Thailand, we draw attention to the condition as a cause of spurious low oxygen saturation. The discrepancy of oxygen saturation between pulse oximetry and arterial blood gas necessitates investigations for hemoglobinopathies.

Keywords : Hemoglobinopathy, Hemoglobin Lansing, Discordance of oxygen saturation


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MEDICAL ASSOCIATION OF THAILAND
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