Neonatal Cyanosis from a Hemoglobin Variant

To the Editor: In their article on a hemoglobin variant associated with neonatal cyanosis and anemia, Crowley et al. (May 12 issue)1 describe their use of testing of arterial blood gases, a review of family medical history, and other tailored testing for well-appearing newborns with cyanosis. Universal screening in the nursery for cyanotic congenital heart disease with the use of pulse oximetry was recently recommended by a federal advisory committee.2 Although the condition described by Crowley et al. is rare, routine neonatal screening for low oxygen saturation will inevitably uncover more patients with hemoglobinopathies with low oxygen affinity.3 We describe . . .