A Case Report of Primaquine Associated Methemoglobinemia in a Man With Pneumocystis Jirovecii Pneumonia Following Cardiac and Renal Transplantation

Transplant Proc. 2024 Mar;56(2):453-455. doi: 10.1016/j.transproceed.2023.12.022. Epub 2024 Feb 9.

Abstract

We describe the case of a 51-year-old Caucasian man with a background of a cardiac and renal transplant who developed Enterocytozoon bieneusi colitis and pneumocystis jirovecii (PJP) pneumonia following treatment for suspected rejection. The patient developed methemoglobinemia which was attributed to primaquine. He was treated with intravenous methylene blue leading to clinical and biochemical resolution. We describe in detail the pathophysiological mechanism for methemoglobinemia and its treatment, in particular with methylene blue.

Publication types

  • Case Reports

MeSH terms

  • Humans
  • Kidney Transplantation* / adverse effects
  • Male
  • Methemoglobinemia* / chemically induced
  • Methemoglobinemia* / complications
  • Methemoglobinemia* / diagnosis
  • Methylene Blue
  • Middle Aged
  • Pneumocystis carinii*
  • Pneumonia, Pneumocystis* / complications
  • Pneumonia, Pneumocystis* / diagnosis
  • Pneumonia, Pneumocystis* / drug therapy
  • Primaquine / adverse effects

Substances

  • Methylene Blue
  • Primaquine