Marshall Journal of Medicine

Article Title

The Role of Arterial Blood Gas in Distinction of Intravascular Hemolysis in a Patient with Lupus Nephritis.

Authors

Ahlim Al Sanani, MD, Marshall University School of Medicine, Huntington, WVFollow

DOI

http://dx.doi.org/10.18590/mjm.2016.vol2.iss3.6

Abstract

Dapsone is a Leprostatic agent routinely used for Malaria, Leprosy and as a prophylaxis for Pneumocystis jiroveci pneumonia (PCP), as well as Toxoplasma gondii in immunocompromised patients. Methemoglobinemia is an adverse effect of dapsone which can be life-threatening. Detailed is a case of dapsone-induced methemoglobinemia in a young woman with lupus nephritis treated with chronic immunosuppressant medications.

Conflict(s) of Interest

N/A

References with DOI

1. Ashurst JV et al. Pathophysiologic mechanisms, diagnosis, and management of dapsone-induced methemoglobinemia. J Am Osteopath Assoc. 2010;110(1):16-20.

2. Burke P, Jahangir K, Kolber MR. Dapsone-induced methemoglobinemia: case of the blue lady. Can Fam Physician. 2013;59(9):958-61.

3. Sangiolo D et al. Toxicity and efficacy of daily dapsone as pneumocystis jiroveci prophylaxis after hematopoietic stem cell transplantation: a case-control study. Biol Blood Marrow Transplant. 2005;11(7):521-9. https://doi.org/10.1016/j.bbmt.2005.04.011

4. Ash-Bernal R, Wise R, Wright SM. Acquired methemoglobinemia: a retrospective series of 138 cases at 2 teaching hospitals. Medicine (Baltimore). 2004;83(5):265-73. https://doi.org/10.1097/01.md.0000141096.00377.3f

5. O'Dwyer D, McElvaney NG. A case of dapsone induced methaemoglobinaemia. Ir J Med Sci. 2008; 177(3):273-5. https://doi.org/10.1007/s11845-008-0176-5

6. Donnelly GB, Randlett D. Images in clinical medicine. Methemoglobinemia. N Engl J Med. 2000;343(5):337. https://doi.org/10.1056/nejm200008033430505

7. Van Malderen C et al., Glucose-6-phosphate dehydrogenase deficiency, chlorproguanil-dapsone with artesunate and post-treatment haemolysis in African children treated for uncomplicated malaria. Malar J. 2012;11:139. https://doi.org/10.1186/1475-2875-11-139

8. Whitwam JG, Taylor AR, White JM. Potential hazard of methylene blue. Anaesthesia. 1979;34(2):181-2. https://doi.org/10.1111/j.1365-2044.1979.tb06275.x

9. Plotkin JS et al. Methemoglobinemia associated with dapsone treatment in solid organ transplant recipients: a two-case report and review. Liver Transpl Surg. 1997;3(2):149-52. https://doi.org/10.1002/lt.500030207

Recommended Citation

Al Sanani, MD, Ahlim (2016) "The Role of Arterial Blood Gas in Distinction of Intravascular Hemolysis in a Patient with Lupus Nephritis.," Marshall Journal of Medicine: Vol. 2: Iss. 3, Article 6.
DOI: http://dx.doi.org/10.18590/mjm.2016.vol2.iss3.6
Available at: https://mds.marshall.edu/mjm/vol2/iss3/6