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Concern for the diagnosis of methemoglobinemia is further increased by any of the following: 11 Prior history of methemoglobinemia Positive family history for methemoglobinemia Positive genetic testing for a disease variant in one of the methemoglobinemia genes Known exposure to methemoglobinemia-inducing substance Because methemoglobin cannot carry oxygen and because the oxygen dissociation curve is shifted to the left, most symptoms (except for cyanosis) related to the blood’s decreased oxygen-carrying capacity