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Dapsone induced methemoglobinemia : Intermittent vs continuous intravenous methylene blue therapy

Rajniti Prasad1, R Singh, O P Mishra

  • 1Department of Pediatrics, Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India. rajniti_prasad@hotmail.com

Indian Journal of Pediatrics
|April 1, 2008
PubMed

Insights

Continuous intravenous methylene blue therapy significantly reduces methemoglobin (MetHb) levels in children with dapsone intoxication compared to intermittent therapy. This approach offers a more effective treatment for methemoglobinemia.

Area of Science:

  • Pediatric Toxicology
  • Pharmacology
  • Emergency Medicine

Background:

  • Dapsone intoxication can lead to life-threatening methemoglobinemia.
  • Methylene blue is a standard treatment for methemoglobinemia.
  • Optimal delivery method for methylene blue in pediatric cases requires further investigation.

Purpose of the Study:

  • To compare the efficacy of intermittent versus continuous intravenous methylene blue therapy.
  • To evaluate the rate of methemoglobin (MetHb) level decline in children with dapsone intoxication.

Main Methods:

  • Eleven children with dapsone intoxication were randomized into two groups.
  • Group I received intermittent methylene blue therapy; Group II received continuous infusion.
  • Blood MetHb levels were measured over 72 hours and analyzed using a student t-test.

Main Results:

  • Continuous methylene blue infusion (Group II) showed a statistically significant decline in MetHb levels compared to intermittent therapy (Group I).
  • Significant differences in MetHb reduction were observed at 12, 24, 36, 48, and 72 hours.
  • Clinical features like seizures and altered sensorium were noted in some patients.

Conclusions:

  • Continuous intravenous methylene blue therapy is more effective than intermittent regimens for treating dapsone-induced methemoglobinemia in children.
  • Continuous infusion leads to a more rapid and significant reduction in blood MetHb levels.
Abstract

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