Rasburicase-induced Methemoglobinemia: A Case Report and Literature Review

Ilaria Pirrone, Piero Farruggia, Francesca Cacciatore, Antonino Giambona, Angela Guarina, Anna Paola Marcello, Clara Mosa, Simona Scalzo, Paolo D'Angelo

Research output: Contribution to journalReview articlepeer-review


Rasburicase is a recombinant urate oxidase enzyme indicated for tumor lysis syndrome, a potential life-threatening oncologic emergency that occurs most commonly during initial chemotherapy for hematological malignancies. As a result of the defects in the physiological antioxidant pathway, erythrocytes of patients with glucose-6-phosphate dehydrogenase deficiency are not protected against the oxidizing stress exerted by hydrogen peroxide generated with the administration of rasburicase. The authors report a 14-year-old patient, diagnosed with T-cell acute lymphoblastic leukemia, who developed methemoglobinemia and hemolytic anemia with low oxygen saturation after starting steroids, hyperhydratation, and rasburicase administration. The complications resolved with supportive therapy only.

Original languageEnglish
Pages (from-to)E886-E890
JournalJournal of Pediatric Hematology/Oncology
Issue number6
Publication statusPublished - Aug 2021


  • childhood
  • hemolysis
  • methemoglobinemia
  • rasburicase

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology


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