Methylene Blue Infusion to Treat Severe Dapsone-Induced Methemoglobinemia in a Pediatric Patient

Bader Alyahya; Abdulaziz Alalshaikh; Ghofran Sabbahi; Mosaed Alnowiser; Mohammed Al-Mohawes

doi:10.7759/cureus.18853

Methylene Blue Infusion to Treat Severe Dapsone-Induced Methemoglobinemia in a Pediatric Patient

Cureus. 2021 Oct 18;13(10):e18853. doi: 10.7759/cureus.18853. eCollection 2021 Oct.

Authors

Bader Alyahya¹, Abdulaziz Alalshaikh¹, Ghofran Sabbahi², Mosaed Alnowiser¹, Mohammed Al-Mohawes³

Affiliations

¹ Emergency Medicine, King Saud University, Riyadh, SAU.
² Pediatric Infectious Diseases, King Abdulaziz University Hospital, Jeddah, SAU.
³ Emergency Medicine, King Saud University , Riyadh, SAU.

Abstract

Dapsone overdose is a well-known potent cause of methemoglobinemia and hemolytic anemia. We discuss a case of a two-year-old male who developed severe persistent methemoglobinemia treated with multiple doses of methylene blue (MB), multidose activated charcoal, and vitamin C. Methylene blue infusion (rather than bolus dosing) aided in controlling this patient's methemoglobin (MetHb) levels and symptoms and may reduce the total needed dose.

Keywords: accidental ingestion; dapsone; methemoglobinemia; methylene blue infusion; toxicity.

Publication types

Case Reports