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Prepublished online as a Blood First Edition Paper on July 5, 2002; DOI 10.1182/blood-2002-05-1405.

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Submitted May 14, 2002
Accepted June 18, 2002

Familial idiopathic methemoglobinemia revisited: original cases reveal 2 novel mutations in NADH-cytochrome b5 reductase

Melanie J Percy*, Matthew J S Gillespie, Geraldine Savage, Anne E Hughes, Mary Frances McMullin, and Terence R J Lappin

Department of Haematology, Belfast City Hospital, Belfast, Northern Ireland, United Kingdom
Department of Haematology, Royal Victoria Hospital, Belfast, Northern Ireland, United Kingdom
Department of Medical Genetics, Queen's University, Belfast, Northern Ireland, United Kingdom
Department of Haematology, Queen's University, Belfast, Northern Ireland, United Kingdom

* Corresponding author; email: melanie.percy{at}bll.n-i.nhs.uk.

In 1943 the first discription of familial idiopathic methemoglobinemia in the United Kingdom was reported in 2 members of one family. Five years later, Quentin Gibson correctly identified the pathway involved in the reduction of methemoglobin in the family, thereby describing the first hereditary trait involving a specific enzyme deficiency. Recessive congenital methemoglobinemia (RCM) is caused by deficiency of NADH-cytochrome b5 reductase. One of the original propositi with the Type I disorder has now been traced. He was found to be a compound heterozygote harboring 2 previously undescribed mutations in exon 9, a point mutation G873A predicting a G291D substitution, and a 3bp in-frame deletion of codon 255 (GAG) predicting loss of glycine. A brother and surviving sister are heterozygous, each bearing one of the mutations. Thirty-three different mutations have now been recorded for RCM. The original authors' optimism that RCM would provide material for future genetic studies has been amply justified.


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