How the Test is Performed

The health care provider wraps a tourniquet or blood pressure cuff around your upper arm. This creates pressure that causes veins below the area to fill with blood.

After cleaning the area with a germ killer (antiseptic), the person performing the test will place a needle into your vein, usually near the inside of the elbow or back of the hand. A thin tube, called a catheter, is then placed into the vein. (It may be called an IV, which means intravenous.) While the tube stays in place, the needle and tourniquet are removed.

A dark green powder called methylene blue goes through the tube into your vein. The health care provider looks at how the powder turns a substance in the blood called methemoglobin into normal hemoglobin.

How to Prepare for the Test

No special preparation is required for this test.

How the Test Will Feel

When the needle is inserted, you may feel moderate pain or a stinging sensation. Afterward, there may be some throbbing.

Why the Test is Performed

There are several types of oxygen-carrying proteins in the blood. One of them is methemoglobin. Normal methemoglobin levels in blood are usually around 1%. At higher levels, it can cause illness because it cannot carry oxygen. Because of its lower oxygen content, methemoglobinemia blood looks brown, rather than red.

Methemoglobinemia has several causes, many of which are genetic. This test is used to tell the difference between methemoglobinemia caused by the lack of a protein called cytochrome b5 reductase and other types that are passed down through families (inherited). Your doctor will use the results of this test to help determine your treatment.

Normal Results

Normally, methylene blue rapidly lowers the levels of methemoglobin in the blood.

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

What Abnormal Results Mean

If methylene blue does not significantly lower blood levels of methemoglobin, the health care provider will suspect a rare form of inherited methemoglobinemia.

Risks

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Inserting an IV may be more difficult for you or your child than for other people.

Other risks associated with this type of blood test are minor, but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken, but the chances of infection increase the longer the IV remains in the vein)

Updated: 4/1/2012

Reviewed by: Chad Haldeman-Englert, MD, Wake Forest University School of Medicine, Department of Pediatrics, Section on Medical Genetics, Winston-Salem, NC. Review provided by VeriMed Healthcare Network.Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.