High-dose vitamin C management in dapsone-induced methemoglobinemia.
Methylene blue is the first-choice treatment of methemoglobinemia, but it is not readily available in most Korean emergency departments because of an import suspension. An 84-year-old woman with dapsone-induced massive methemoglobinemia visited our emergency department for unclear mentality and cyanosis. Because methylene blue was not available, we intravenously administrated vitamin C (VC) for symptomatic methemoglobinemia, although VC is not a universally accepted treatment. Vitamin C (10 g intravenously) administered 6 hourly successfully treated the dapsone-induced methemoglobinemia and did not adversely affect renal functions. Thus,we recommend that if methylene blue is unavailable, 6 hourly intravenous administrations of 10 g of VC should be considered for dapsone-induced methemoglobinemia.
Department of Emergency Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
Sin-Youl
SY
Park
Department of Emergency Medicine, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea.
Kyung-Woo
KW
Lee
Department of Emergency Medicine, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea.
Tae-Sin
TS
Kang
D000369:Aged, 80 and over; D001205:Ascorbic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D003622:Dapsone / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008706:Methemoglobin / Q000032:analysis; D008708:Methemoglobinemia / Q000139:chemically induced*; D014815:Vitamins / Q000008:administration & dosage / Q000627:therapeutic use*
D014815:Vitamins; D003622:Dapsone; D008706:Methemoglobin; D001205:Ascorbic Acid