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Acute dapsone intoxication: a case with prolonged symptoms.

E Elonen, P J Neuvonen, J Halmekoski

    Clinical Toxicology
    |January 1, 1979
    PubMed
    Summary
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    Acute dapsone (DDS) poisoning caused methemoglobinemia and hemolysis. Activated charcoal administration significantly reduced DDS and monoacetyldapsone (MADDS) half-lives, suggesting its efficacy in treating DDS overdose.

    Area of Science:

    • Pharmacology
    • Toxicology
    • Clinical Medicine

    Background:

    • Dapsone (DDS) is a medication with a narrow therapeutic index.
    • Acute DDS overdose can lead to severe toxicity, including methemoglobinemia and hemolysis.
    • Understanding DDS pharmacokinetics is crucial for managing overdose cases.

    Observation:

    • A 45-year-old male ingested 10 gm of DDS, presenting with vomiting, methemoglobinemia, cyanosis, headache, and confusion.
    • Hemolysis was observed starting on day 3 post-ingestion, peaking over a week later.
    • Initial DDS and monoacetyldapsone (MADDS) elimination was slow, with half-lives of 88 and 67 hours, respectively.

    Findings:

    • Methemoglobinemia resolved within 7 days as DDS and MADDS levels reached therapeutic concentrations.

    Related Experiment Videos

  • Oral activated charcoal administration markedly reduced the half-lives of both DDS and MADDS.
  • The observed enterohepatic recirculation of DDS is supported by the charcoal's effectiveness.

    • Implications:

    • Activated charcoal is a recommended intervention for acute DDS poisoning.
    • Prolonged administration of activated charcoal may be beneficial due to DDS enterohepatic cycling.
    • This case highlights the importance of pharmacokinetic monitoring and timely intervention in DDS overdose.