Clinical and laboratory parameters in dapsone acute intoxication.
OBJECTIVE
To determine the severity of dapsone (DDS) acute intoxication - an uncommon medical event - using clinical and laboratory parameters.


METHODS
Two hundred and seventy four patients with acute DDS intoxication, aged 1 month to 50 years old, were studied and classified into four age groups. Clinical evaluation was assessed through a protocol and correlated with laboratory parameters. Spectrophotometric methods were used to analyze methemoglobinemia (MHbp) and dapsonemia (DDSp).


RESULTS
The most prevalent clinical sign of intoxication was cyanosis, seen in 65.7% of the patients and in 100% of children less than 5 years of age. According to laboratory criteria, MHbp-related severe clinical intoxication was seen in 56.2% and DDSp-related occurred in 58% of the patients. Regarding DDSp, intoxication was considered severe when 20 tablets (100 mg each) were ingested, a median of 29 microg/ml. Regarding MHbp, intoxication was severe when 7.5 tablets were ingested, a median of 38% of the total Hb. The correlation between MHbp and DDSp was statistically significant (n=144, r=0.32, p<0.05). Negative correlation was observed between MHbp and the time elapsed since DDS intake (n=124, r=-0.34, p<0.001). There was also a negative correlation between DDSp and the time elapsed since DDS intake (n=63, r=-0.35, p<0.0001).


CONCLUSIONS
Longitudinal analysis showed a significant association between methemoglobinemia and the time elapsed after the intake (t), according to the equation: Dapsonemia = 12.9256 - 0.0682t + 0.234 methemoglobinemia
Carrazza
M Z
MZ
Programa de Controle de Intoxicações, Secretaria de Saúde do Município de São Paulo, São Paulo, SP, Brasil. carraz@usp.br
Carrazza
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Oga
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D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003490:Cyanosis / Q000139:chemically induced; D003622:Dapsone / Q000506:poisoning*; D005260:Female; D006801:Humans; D007223:Infant; D007917:Leprostatic Agents / Q000506:poisoning*; D008137:Longitudinal Studies; D008297:Male; D008708:Methemoglobinemia / Q000097:blood / Q000139:chemically induced*; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
D007917:Leprostatic Agents; D003622:Dapsone