Sulfhemoglobinemia after dermal application of DMSO.

Abstract

A 43-y-old Caucasian female applied 4 ounces of dimethyl sulfoxide (DMSO) to her lower abdomen for treatment of interstitial cystitis. Within 24 h she developed fatigue, cyanosis and dyspnea with mild exertion. She sought medical attention 10 d later, at which time initial laboratory tests revealed a methemoglobin level of 47%. Two doses of 1 mg methylene blue/kg i.v. were given without significant improvement in either her cyanosis or methemoglobin level. Repeat analysis the day following admission using an outside lab demonstrated a sulfhemoglobin level of 6.2% and a methemoglobin level of < 0.1%. No prior reports have associated sulfhemoglobin formation with DMSO application. Carbon monoxide-oximetry may falsely identify sulfhemoglobin as methemoglobin; sulfhemoglobinemia should be considered in cases of methemoglobinemia refractory to methylene blue therapy.

• Authors: J L Burgess, A P Hamner, W O Robertson
• Journal: Veterinary and human toxicology (Vet Hum Toxicol) Vol. 40 Issue 2 Pg. 87-9 (Apr 1998) ISSN: 0145-6296 [Print] United States
• PMID: 9554060 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Infective Agents, Urinary
• Anti-Inflammatory Agents
• Carbon Monoxide
• Methemoglobin
• Sulfhemoglobin
• Methylene Blue
• Dimethyl Sulfoxide

Topics

• Administration, Topical
• Adult
• Anti-Infective Agents, Urinary (therapeutic use)
• Anti-Inflammatory Agents (administration & dosage, adverse effects)
• Carbon Monoxide (analysis)
• Cystitis, Interstitial (blood, drug therapy)
• Diagnostic Errors
• Dimethyl Sulfoxide (administration & dosage, adverse effects)
• Erythrocyte Transfusion
• Female
• Humans
• Methemoglobin (analysis)
• Methemoglobinemia (chemically induced, drug therapy)
• Methylene Blue (therapeutic use)
• Sulfhemoglobin (analysis)
• Sulfhemoglobinemia (blood, chemically induced, drug therapy)