High-dose vitamin C management in dapsone-induced methemoglobinemia.

Abstract

Methylene blue is the first-choice treatment of methemoglobinemia, but it is not readily available in most Korean emergency departments because of an import suspension. An 84-year-old woman with dapsone-induced massive methemoglobinemia visited our emergency department for unclear mentality and cyanosis. Because methylene blue was not available, we intravenously administrated vitamin C (VC) for symptomatic methemoglobinemia, although VC is not a universally accepted treatment. Vitamin C (10 g intravenously) administered 6 hourly successfully treated the dapsone-induced methemoglobinemia and did not adversely affect renal functions. Thus,we recommend that if methylene blue is unavailable, 6 hourly intravenous administrations of 10 g of VC should be considered for dapsone-induced methemoglobinemia.

• Authors: Sin-Youl Park, Kyung-Woo Lee, Tae-Sin Kang
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 32 Issue 6 Pg. 684.e1-3 (Jun 2014) ISSN: 1532-8171 [Electronic] United States
• PMID: 24439259 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Vitamins
• Dapsone
• Methemoglobin
• Ascorbic Acid

Topics

• Aged, 80 and over
• Ascorbic Acid (administration & dosage, therapeutic use)
• Dapsone (adverse effects)
• Female
• Humans
• Methemoglobin (analysis)
• Methemoglobinemia (chemically induced)
• Vitamins (administration & dosage, therapeutic use)