A rare case of massive retroperitoneal hemorrhage after bone marrow aspiration alone.
The use of dapsone is increasing even though overdose is rarely reported and physicians must be aware of its toxicity and management. Mortality can occur due to methemoglobinemia and hemolytic anemia. Although activated charcoal and methylene blue are recommended, the use of hemodialysis is reported only in few studies. Literature on the kinetic profile indicates that 50% to 80% of dapsone is protein bound and indicates a possibility to dialyze the unbound form. This study describes a case of deliberate severe dapsone overdose with cyanosis, methemoglobinemia, and hemolytic anemia, which improved after repetitive hemodialysis.
Tsai
Hsien-Lung
HL
Emergency Department, Taipei Veterans General Hospital, Taipei 112, Taiwan.
Liu
Shih-Wei
SW
How
Chorng-Kuang
CK
Chern
Chii-Hwa
CH
Yen
David Hung-Tsang
DH
Huang
Chun-I
CI
D000328:Adult; D001856:Bone Marrow Examination / Q000009:adverse effects*; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D012187:Retroperitoneal Space