A Case of Cyanosis With Saturation Gap: Dapsone-Induced Methemoglobinemia

Mahammed Khan Suheb; Farheen Naaz; Tyler K Anderson; Alexander McClanahan

doi:10.7759/cureus.31684

A Case of Cyanosis With Saturation Gap: Dapsone-Induced Methemoglobinemia

Cureus. 2022 Nov 19;14(11):e31684. doi: 10.7759/cureus.31684. eCollection 2022 Nov.

Authors

Mahammed Khan Suheb¹, Farheen Naaz², Tyler K Anderson³, Alexander McClanahan⁴

Affiliations

¹ Internal Medicine, University of Nebraska Medical Center, Omaha, USA.
² Internal Medicine, Deccan College of Medical Sciences, Hyderabad, IND.
³ Orthopedics, University of Central Florida College of Medicine, Orlando, USA.
⁴ General Surgery, University of Central Florida College of Medicine, Orlando, USA.

Abstract

Dapsone is an antibiotic used in the management of dermatologic infections and opportunistic infection prophylaxis in developed countries. Methemoglobinemia (MetHb) is a known complication of dapsone use that can result in cyanosis. MetHb is an aberrant form of hemoglobin produced physiologically by auto-oxidation. An impairment in the process of auto-oxidation due to genetic defects or the use of drugs/toxins causes its levels to rise. Management involves timely recognition and the use of methylene blue (MB) or ascorbic acid. We describe the diagnosis and management of a patient with acquired MetHb as a result of dapsone use.

Keywords: auto-oxidation; cyanosis; dapsone side effect; dapsone-induced methemoglobinemia; methylene blue; saturation gap.

Publication types

Case Reports