• Am J Emerg Med · Oct 2020

    Case Reports

    Whole bowel irrigation in dapsone intoxication with persistent methemoglobinemia: A case report.

    • Indalecio Carboni Bisso, Nicolás Gemelli, Maria Paula Cordero, Cecilia Barrios, and Daniel Pina.
    • Intensive Care Unit, Sanatorio Franchin, Buenos Aires, Argentina. Electronic address: icarbonibisso@asmsa.com.ar.
    • Am J Emerg Med. 2020 Oct 1; 38 (10): 2246.e1-2246.e2.

    AbstractDapsone intoxication can be a life-threatening condition due its enterohepatic recirculation pharmacokinetics, and therefore, persistent methemoglobinemia development. We describe a case of a 17-year-old girl who was admitted 4 h after ingesting 5 g of dapsone. She presented methemoglobinemia (39%) and showed clinical signs of toxicity (cyanosis and altered mental status) despite mechanical ventilation. Multiple activated charcoal dosis and methylene blue infusions were performed. Notwithstanding initial improvement, a pattern of peaks and valleys was observed in serial methemoglobinemia measurements, with cyclic states of hypoxemia. On account of enterohepatic recirculation pharmacokinetics, clearance was enhanced by whole bowel irrigation. After 7 days of hospitalization, she was discharged in good general condition.Copyright © 2020 Elsevier Inc. All rights reserved.

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