Dapsone intoxication: Two case reports
Identifieur interne : 001A29 ( Istex/Checkpoint ); précédent : 001A28; suivant : 001A30Dapsone intoxication: Two case reports
Auteurs : Duane G. Hansen [États-Unis] ; Kathryn R. Challoner [États-Unis] ; Dallas E. Smith [États-Unis]Source :
- Journal of Emergency Medicine [ 0736-4679 ] ; 1994.
English descriptors
- Teeft :
- Acute dapsone intoxication, Arterial blood, Arterial blood gases, Ascorbic acid, Blood pressure mmhg, Case report, Charcoal hemoperfusion, Clin toxicol, Dapsone, Dapsone intoxication, Dapsone overdose, Dapsone poisoning, Dehydrogenase deficiency, Dermatitis herpetiformis, Dos, Elimination half, Emergency medicine, Face mask, Gastric decontamination, Gastric lavage, Hemolytic anemia, Hours postingestion, Ingestion, Intensive care unit, Intoxication, Methemoglobin, Methemoglobin concentration, Methemoglobin concentrations, Methemoglobin levels, Methemoglobinemia, Methylene, Mmhg, Nasogastric tube, Overdose, Oxygen saturation, Plasma exchange, Pulse rate, Respiratory rate, Reticulocyte count, Serum methemoglobin level, Southern california, Symptomatic methemoglobinemia, Toxic metabolites, Vital signs.
Abstract
Abstract: Two patients with dapsone intoxication, an adult and a 16-month-old child, are reported. Both developed symptomatic methemoglobin concentrations, of 35% and 37%, respectively, and improved with intravenous methylene blue. Methemoglobin levels subsequently rose in both cases to 25% at 24 and 37 hours, respectively. The recurrence of elevated methemoglobin levels resulted from either continued absorption of dapsone or its toxic metabolite from the gastrointestinal tract. Both patients were begun on serial oral activated charcoal and the child received a second methylene blue treatment. During the intoxication, serum hemoglobin concentrations dropped 2 gm with an increase in the reticulocyte count. Review of 20 cases of dapsone overdose from the literature showed that the major toxic manifestations are methemoglobinemia and hemolysis. Delayed sulfhemoglobinemia, reported in only one case, resolved spontaneously. The treatment of dapsone intoxication is intravenous methylene blue for symptomatic methemoglobinemia, gastric decontamination, and early administration of serial oral activated charcoal. Hemolysis is mild but transfusions may be required for patients with a glucose-6-phosphate dehydrogenase deficiency.
Url:
DOI: 10.1016/0736-4679(94)90277-1
Affiliations:
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ISTEX:C60C5416821BFA12F26CB357972D7D2AA68C0BCELe document en format XML
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<wicri:regionArea>Assistant Professor of Clinical Emergency Medicine, The Department of Emergency Medicine, University of Southern California School of Medicine and Los Angeles County/University of Southern California Medical Center, Los Angeles, California</wicri:regionArea>
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<term>Blood pressure mmhg</term>
<term>Case report</term>
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<term>Clin toxicol</term>
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<term>Dapsone intoxication</term>
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<term>Dermatitis herpetiformis</term>
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<term>Elimination half</term>
<term>Emergency medicine</term>
<term>Face mask</term>
<term>Gastric decontamination</term>
<term>Gastric lavage</term>
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<term>Respiratory rate</term>
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<front><div type="abstract" xml:lang="en">Abstract: Two patients with dapsone intoxication, an adult and a 16-month-old child, are reported. Both developed symptomatic methemoglobin concentrations, of 35% and 37%, respectively, and improved with intravenous methylene blue. Methemoglobin levels subsequently rose in both cases to 25% at 24 and 37 hours, respectively. The recurrence of elevated methemoglobin levels resulted from either continued absorption of dapsone or its toxic metabolite from the gastrointestinal tract. Both patients were begun on serial oral activated charcoal and the child received a second methylene blue treatment. During the intoxication, serum hemoglobin concentrations dropped 2 gm with an increase in the reticulocyte count. Review of 20 cases of dapsone overdose from the literature showed that the major toxic manifestations are methemoglobinemia and hemolysis. Delayed sulfhemoglobinemia, reported in only one case, resolved spontaneously. The treatment of dapsone intoxication is intravenous methylene blue for symptomatic methemoglobinemia, gastric decontamination, and early administration of serial oral activated charcoal. Hemolysis is mild but transfusions may be required for patients with a glucose-6-phosphate dehydrogenase deficiency.</div>
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