Identifying the Cause of the "Saturation Gap": Two Cases of Dapsone-induced Methemoglobinemia
Diaphenylsulfone (DDS: Dapsone) is used for Pneumocystis pneumonia (PCP) prophylaxis, and methemoglobinemia has rarely been reported as a side effect of DDS. We herein report two cases of DDS-related methemoglobinemia in an 81-year-old man with organizing pneumonia and an 84-year-old woman with eosi...
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| Veröffentlicht in: | Internal Medicine 2015, Vol.54(13), pp.1639-1641 |
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| creator | Furuta, Kenjiro Ikeo, Satoshi Takaiwa, Takuya Ikeda, Satoshi Nishiyama, Akihiro Yokoyama, Toshihide Ito, Akihiro Tokioka, Fumiaki Tanaka, Maki Yoshioka, Hiroshige Tachibana, Hiromasa Arita, Machiko Hashimoto, Toru Ishida, Tadashi |
| description | Diaphenylsulfone (DDS: Dapsone) is used for Pneumocystis pneumonia (PCP) prophylaxis, and methemoglobinemia has rarely been reported as a side effect of DDS. We herein report two cases of DDS-related methemoglobinemia in an 81-year-old man with organizing pneumonia and an 84-year-old woman with eosinophilic pneumonia under treatment with prednisolone. Both patients initially received trimethoprim/sulfamethoxazole for PCP prophylaxis and were switched to DDS due to side effects and subsequently exhibited a clinically unexplainable decrease in SpO2. Methemoglobinemia was diagnosed based on the findings of arterial blood gas analyses. In both cases, the methemoglobinemia improved after discontinuing DDS. |
| doi_str_mv | 10.2169/internalmedicine.54.3496 |
| format | Article |
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We herein report two cases of DDS-related methemoglobinemia in an 81-year-old man with organizing pneumonia and an 84-year-old woman with eosinophilic pneumonia under treatment with prednisolone. Both patients initially received trimethoprim/sulfamethoxazole for PCP prophylaxis and were switched to DDS due to side effects and subsequently exhibited a clinically unexplainable decrease in SpO2. Methemoglobinemia was diagnosed based on the findings of arterial blood gas analyses. 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Med.</addtitle><description>Diaphenylsulfone (DDS: Dapsone) is used for Pneumocystis pneumonia (PCP) prophylaxis, and methemoglobinemia has rarely been reported as a side effect of DDS. We herein report two cases of DDS-related methemoglobinemia in an 81-year-old man with organizing pneumonia and an 84-year-old woman with eosinophilic pneumonia under treatment with prednisolone. Both patients initially received trimethoprim/sulfamethoxazole for PCP prophylaxis and were switched to DDS due to side effects and subsequently exhibited a clinically unexplainable decrease in SpO2. Methemoglobinemia was diagnosed based on the findings of arterial blood gas analyses. In both cases, the methemoglobinemia improved after discontinuing DDS.</description><subject>Aged, 80 and over</subject><subject>Anti-Infective Agents - administration & dosage</subject><subject>Anti-Infective Agents - adverse effects</subject><subject>Antibiotic Prophylaxis - methods</subject><subject>Cryptogenic Organizing Pneumonia - drug therapy</subject><subject>dapsone</subject><subject>Dapsone - administration & dosage</subject><subject>Dapsone - adverse effects</subject><subject>diaphenylsulfone</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>methemoglobinemia</subject><subject>Methemoglobinemia - chemically induced</subject><subject>Methemoglobinemia - drug therapy</subject><subject>Pneumonia, Pneumocystis - prevention & control</subject><subject>saturation gap</subject><subject>Treatment Outcome</subject><subject>Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkMFO3DAQhq2qVVkor4AiTr1kie04TrhVSwtIVBxKj8iaOOPFKLG3tqOKt6-XXfaAKo1mNJrvnxn9hBS0WjLadBfWJQwOxgkHq63DpaiXvO6aD2RBcy0l4-IjWVQdbUuW0xE5jvG5qngrO_aZHLEmY7STC_J4O6BL1rxYty7SExYrmCMW3rw2578gzQGS9a64hs35ZfHw12ckYtwiV7CJ3mFp3TBrHIqfmEWTX4--z09NFr6QTwbGiKf7ekJ-__j-sLop7-6vb1ff7kot2jqVvGambyTtGetFx3IMYhASjYbWdDL_DGCaqtaVYLJvtJGDQQGccyY1VoyfkK-7vZvg_8wYk5ps1DiO4NDPUWXPuKQ1Z3VG2x2qg48xoFGbYCcIL4pWamuuem-uErXampulZ_src5-HB-Gbmxm43wHPMcEaDwCEZPWI_91M-TbvTxxI_QRBoeP_ANjJmCo</recordid><startdate>20150101</startdate><enddate>20150101</enddate><creator>Furuta, Kenjiro</creator><creator>Ikeo, Satoshi</creator><creator>Takaiwa, Takuya</creator><creator>Ikeda, Satoshi</creator><creator>Nishiyama, Akihiro</creator><creator>Yokoyama, Toshihide</creator><creator>Ito, Akihiro</creator><creator>Tokioka, Fumiaki</creator><creator>Tanaka, Maki</creator><creator>Yoshioka, Hiroshige</creator><creator>Tachibana, Hiromasa</creator><creator>Arita, Machiko</creator><creator>Hashimoto, Toru</creator><creator>Ishida, Tadashi</creator><general>The Japanese Society of Internal Medicine</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150101</creationdate><title>Identifying the Cause of the "Saturation Gap": Two Cases of Dapsone-induced Methemoglobinemia</title><author>Furuta, Kenjiro ; 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| subjects | Aged, 80 and over Anti-Infective Agents - administration & dosage Anti-Infective Agents - adverse effects Antibiotic Prophylaxis - methods Cryptogenic Organizing Pneumonia - drug therapy dapsone Dapsone - administration & dosage Dapsone - adverse effects diaphenylsulfone Female Humans Male methemoglobinemia Methemoglobinemia - chemically induced Methemoglobinemia - drug therapy Pneumonia, Pneumocystis - prevention & control saturation gap Treatment Outcome Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use |
| title | Identifying the Cause of the "Saturation Gap": Two Cases of Dapsone-induced Methemoglobinemia |
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