Reactions 1453 - 25 May 2013 S Dapsone Methaemoglobinaemia: case report A 17-year-old girl developed methaemoglobinaemia while receiving dapsone for autoimmune lipoatrophic panniculitis (ALP). The girl presented at an emergency department with the complaint of headache. She had recently started dapsone 50 mg/day for ALP treatment [route and exact duration of therapy before reaction onset not stated]. The previous day, her dapsone dosage had been increased to 100 mg/day. She was tachycardic and hypertensive, and exhibited a marked central cyanosis. Blood tests showed a methaemoglobin level of 23%. The girl was treated with IV methylene blue, and within 10 minutes the cyanosis resolved and her HR normalised. A repeat test showed a methaemoglobin level of 2.9%. However, she required a further dose of methylene blue 10 hours later for recurrent cyanosis with chest pain. Her methaemoglobin level was found to be 8.1%. At hospital discharge, she was recommenced on dapsone 100mg in combination with cimetidine [outcome not stated]. Author comment: "The acute manifestation of methemoglobinemia that our patient presented with was most likely due to the rapid dose escalation of dapsone". Jacobs D, et al. Methemoglobinemia secondary to rapid dose escalation of dapsone. Clinical Toxicology 51: 291-292, No. 4, May 2013. Available from: URL: http://dx.doi.org/10.3109/15563650.2013.785188 [Abstract]. - USA 803087245 1 Reactions 25 May 2013 No. 1453 0114-9954/10/1453-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

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Reactions 1453 - 25 May 2013

SDapsone

Methaemoglobinaemia: case reportA 17-year-old girl developed methaemoglobinaemia while

receiving dapsone for autoimmune lipoatrophic panniculitis(ALP).

The girl presented at an emergency department with thecomplaint of headache. She had recently started dapsone50 mg/day for ALP treatment [route and exact duration oftherapy before reaction onset not stated]. The previous day, herdapsone dosage had been increased to 100 mg/day. She wastachycardic and hypertensive, and exhibited a marked centralcyanosis. Blood tests showed a methaemoglobin level of 23%.

The girl was treated with IV methylene blue, and within10 minutes the cyanosis resolved and her HR normalised. Arepeat test showed a methaemoglobin level of 2.9%. However,she required a further dose of methylene blue 10 hours laterfor recurrent cyanosis with chest pain. Her methaemoglobinlevel was found to be 8.1%. At hospital discharge, she wasrecommenced on dapsone 100mg in combination withcimetidine [outcome not stated].

Author comment: "The acute manifestation ofmethemoglobinemia that our patient presented with wasmost likely due to the rapid dose escalation of dapsone".Jacobs D, et al. Methemoglobinemia secondary to rapid dose escalation ofdapsone. Clinical Toxicology 51: 291-292, No. 4, May 2013. Available from:URL: http://dx.doi.org/10.3109/15563650.2013.785188 [Abstract]. -USA 803087245