Dapsone intoxication: clinical course and characteristics.
OBJECTIVE
Dapsone is used as an antibiotic for leprosy and for dermatological disorders and may cause methemoglobinemia. The aims of this study are to analyze the clinical characteristics of patients presenting to the emergency department (ED) with dapsone ingestion to identify risk factors associated with mortality.


METHODS
We conducted a retrospective observational study of adult ED patients with methemoglobinemia because of dapsone intoxication admitted to a tertiary care hospital from September 2003 to December 2008. Data collected included demographic, clinical, and laboratory characteristics, as well as survival to discharge. Characteristics of young (less than or equal to 55 years) and older (greater than age 55) patients were compared. The main outcome was in-hospital mortality.


RESULTS
There were 46 patients included in the study. The minimum intoxication dose was two 100 mg tablets and the maximum was 100 tablets. Changes in mental status were more common in the older patients. Methemoglobin levels were slightly higher in the younger patients, but both groups were treated with similar doses of methylene blue. Shock and death were more common in the older patients.


CONCLUSIONS
Late presentation to medical care and an altered mental status at the time of presentation were predictive of death after dapsone intoxication. Methemoglobin levels tended to be higher in those who died.
Park
Kyung Hye
KH
Department of Emergency Medicine, Jeju National University Hospital, Jeju, Republic of Korea.
Kim
Hyun
H
Lee
Christopher Chongseo
CC
Cha
Kyung Chul
KC
Park
Seung Min
SM
Ji
Ho Jin
HJ
Do
Han Ho
HH
Lee
Kang Hyun
KH
Hwang
Sung Oh
SO
Singer
Adam J
AJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003622:Dapsone / Q000506:poisoning*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008708:Methemoglobinemia / Q000139:chemically induced; D008875:Middle Aged; D012189:Retrospective Studies
D003622:Dapsone