Respir Case Rep. 2021; 10(2): 148-151 | DOI: 10.5505/respircase.2021.52385

Dapsone Kullanýmýna Baðlý Geliþen Methemoglobinemi Olgusu

Emine Aksoy, Özlem Yazýcýoðlu Moçin
Saðlýk Bilimleri Üniversitesi Süreyyapaþa Göðüs Hastalýklarý ve Göðüs Cerrahisi Eðitim ve Araþtýrma Hastanesi, Ýstanbul

Methemoglobinemi, sýklýkla Dapsone ve Benzocain gibi ilaçlarýn kullanýmýyla ortaya çýkan hayatý tehdit eden bir durumdur. Dapson, B5 redüktaz enzimini inhibe ederek eritrositlerde oksidasyonu azaltarak methemoglobinemiye neden olur. Bu makale de ürtiker nedeniyle bir ay boyunca 100 mg / gün dapson kullanan methemoglobinemi olgusu sunuldu. Hasta bir haftadýr devam eden eforla halsizlik, ateþ, terleme, peri-oral, periferik siyanoz ve cilt lezyonlarý ile baþvurdu. Pulse oksimetre ile ölçülen oksijen satürasyonu % 88 idi. Arteryel kan gazýndaki (AKG) methemoglobin (MetHb) seviyesi taný anýnda% 10,7 idi. Hastanýn takibinde, oksijen desteði verildi ve Dapsone tedavisi kesildi. Hasta klinik takipte iyiydi ve 7. günde AKG'da MetHb düzeyi normal sýnýrlardaydý (% 2,8) ve siyanoz saptanmadý. Daha önce akciðer veya kalp hastalýðý olmayan siyanoz ile baþvuran bir hastada methemoglobinemi akýlda tutulmalý ve ilaç öyküsü de sorgulanmalýdýr.

Anahtar Kelimeler: Dapson, Methemoglobinemi, Ýlaca baðlý komplikasyonlar.

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A Case with Methemoglobinemia due to Use of Dapsone

Emine Aksoy, Özlem Yazýcýoðlu Moçin
University of Health Sciences Süreyyapaþa Chest Diseases and Thoracic Surgery Education and Research Hospital, Ýstanbul, Turkey

Methemoglobinemia is a lethal condition that is most commonly seen with use of drugs such as dapsone and Benzocain. Methemoglobinemia associated with dapsone use is a result of decreased oxidation in erythrocytes due to the inhibition of the B5 reductase enzyme. We present here a case who developed methemoglobinemia while taking dapsone 100mg/day for a month due to urticaria. The male patent developed such symptoms as malaise, sub-febrile fever, sweating, peri-oral and peripheral cyanosis with exertion, and skin lesions for a week. Oxygen saturation with pulse oxymetry was 88%, and the methemoglobin (MetHb) level in the arterial blood gases (ABG) was 10.7% at time of diagnosis. The patient was monitored, oxygen was initiated and dapsone was discontinued. The patient recovered during follow-up and the MetHb level became normal (2.8%) in ABG on the 7th day, and the cyanosis disappeared. Patients presenting with cyanosis and with no known previous pulmonary or cardiac disease should be evaluated for Methemoglobinemia, and drug history of the patient should also be reviewed.

Keywords: Dapsone, Methemoglobinemia, Drugrelated complications.

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