title: A rare case of massive retroperitoneal hemorrhage after bone marrow aspiration alone.
abstract: 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.
authors.affiliation: Emergency Department, Taipei Veterans General Hospital, Taipei 112, Taiwan.
authors.forename: Hsien-Lung
authors.initials: HL
authors.lastname: Tsai
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Liu
authors.forename: Chorng-Kuang
authors.initials: CK
authors.lastname: How
authors.forename: Chii-Hwa
authors.initials: CH
authors.lastname: Chern
authors.forename: David Hung-Tsang
authors.initials: DH
authors.lastname: Yen
authors.forename: Chun-I
authors.initials: CI
authors.lastname: Huang
mesh_terms: D000328:Adult; D001856:Bone Marrow Examination / Q000009:adverse effects*; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D012187:Retroperitoneal Space