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Living with Hereditary methemoglobinemia

An inherited blood condition that causes a bluish tint to the skin and lips early in life.

Understanding Hereditary methemoglobinemia

Hereditary methemoglobinemia is an inherited condition in which blood carries oxygen less well, causing a bluish skin color (cyanosis).

It shows early in life, with no signs of heart or lung disease. It is caused by a missing enzyme (NADH methemoglobin reductase) or by an abnormal hemoglobin called hemoglobin M. Some people also have nervous system problems.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Bluish skin (cyanosis)
  • Bluish or discolored lips
  • Nail changes
  • Shortness of breath with exertion
  • Nervous system problems
  • Methemoglobin in the blood

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include blood and bone marrow specialists, brain and nervous system specialists and genetic specialists.

  3. Consider genetic testing

    Changes in CYB5R3 are linked to this condition. Genetic testing and counseling can help confirm a diagnosis and explain what it means for your family.

Care & treatment

Care team
Blood and bone marrow specialists (hematologists); Brain and nervous system specialists (neurologists); Genetic specialists (geneticists)
Expert care
Ask about multidisciplinary care centers for rare conditions
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with rare disease patient organizations for support
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Is my condition due to an enzyme problem or hemoglobin M?
Could genetic testing for the CYB5R3 gene help our family?
Should the nervous system be monitored?

Quick facts

Symptoms usually startNewborn and as an Infant
InheritanceAutosomal Recessive
GenesCYB5R3

It is caused by changes in the CYB5R3 gene. It is autosomal recessive, so a child inherits a changed copy of the gene from each parent.

GeneticNeurologicalBlood

Also known as: autosomal recessive methemoglobinemia; congenital methemoglobinemia

Patient organizations

Rare-disease groups that can help

Source: NIH GARD · Hereditary methemoglobinemiaGARD ID 2659 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with Hereditary methemoglobinemia.

Explore the Hereditary methemoglobinemia blog

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Explore actively recruiting Hereditary methemoglobinemia studies with HealthSpark.

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