title: Drug-induced methaemoglobinaemia following elective coronary artery bypass grafting.
abstract: Dapsone can alter the oxygen carrying capacity of haemoglobin. Some patients are more susceptible to these effects because of genetic factors, comorbidities or peri-operative factors such as anaemia. We present a 57-year-old lady who underwent elective coronary artery bypass grafting. Deterioration in neurological and respiratory condition prompted a review of her drug treatment. A combination of long-term dapsone therapy, co-existing cardiac and respiratory disease, postoperative anaemia and renal impairment contributed to her decompensation, despite a relatively low level of methaemoglobin. Successful management included stopping dapsone therapy, supportive care and administration of ascorbic acid.
authors.affiliation: Broomfield Hospital, Chelmsford CM1 7ET, UK.
authors.forename: A
authors.initials: A
authors.lastname: Choi
authors.forename: A
authors.initials: A
authors.lastname: Sarang
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D000975:Antioxidants / Q000627:therapeutic use; D001205:Ascorbic Acid / Q000627:therapeutic use; D001026:Coronary Artery Bypass; D003622:Dapsone / Q000009:adverse effects*; D005260:Female; D006801:Humans; D002534:Hypoxia, Brain / Q000139:chemically induced; D008708:Methemoglobinemia / Q000139:chemically induced* / Q000188:drug therapy; D008875:Middle Aged; D011183:Postoperative Complications
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000975:Antioxidants; D003622:Dapsone; D001205:Ascorbic Acid