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Delayed sulfhemoglobinemia after acute dapsone intoxication

M Lambert, J Sonnet, P Mahieu

    Journal of Toxicology. Clinical Toxicology
    |March 1, 1982
    PubMed
    Summary

    This case study details acute Dapsone intoxication from a 3g overdose, leading to severe methemoglobinemia and cyanosis. Repeated methylene blue treatments were necessary due to relapses, highlighting the need for prolonged patient monitoring.

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    Area of Science:

    • Toxicology
    • Pharmacology
    • Emergency Medicine

    Background:

    • Dapsone is a medication used to treat leprosy and certain skin conditions.
    • Acute Dapsone intoxication can occur following intentional or accidental overdose.
    • Severe Dapsone overdose can lead to life-threatening hematological complications.

    Observation:

    • A patient intentionally ingested 3 grams of Dapsone, resulting in acute intoxication.
    • The patient presented with severe methemoglobinemia, cyanosis, dyspnea, headache, and nausea.
    • Sulfhemoglobinemia and mild hemolytic anemia were subsequently observed, prolonging cyanosis.

    Findings:

    • Methemoglobinemia relapsed multiple times despite initial methylene blue treatment.
    • Repeated administration of the reducing agent, methylene blue, was required to manage recurrent methemoglobinemia.

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  • The intoxication resulted in prolonged cyanosis due to the development of sulfhemoglobinemia.

    • Implications:

    • This case underscores the critical need for intensive and prolonged monitoring in acute Dapsone intoxication.
    • Effective management requires vigilant observation for delayed or relapsing hematological abnormalities.
    • Healthcare providers should be prepared for potential complications and the need for repeated therapeutic interventions.