J Korean Soc Emerg Med.
2023 Aug;34(4):379-382.
A case of acute kidney injury caused by dapsone-induced methemoglobinemia in a patient with chronic kidney disease
- Affiliations
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- 1Department of Emergency Medicine, Presbyterian Medical Center, Jeonju, Korea
- 2Nephrology Division, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
Abstract
- Methemoglobinemia (MetHb), which is characterized by an increased methemoglobin level, is a rare but potentially fatal disorder caused by congenital enzyme deficiencies or exposure to oxidizing agents, including dapsone. Elevation in the methemoglobin level impairs the oxygen-carrying capacity of hemoglobin, produces functional anemia, and induces tissue hypoxia. Such hypoxia results in microcirculation injury and hypoperfusion in the tissue and organs, including the kidney, and is a risk factor for acute kidney injury (AKI). This paper reports a case of AKI caused by dapsone-induced MetHb in a patient with chronic kidney disease, in which the patient ingested approximately 1,500 mg of dapsone in a suicide attempt, which was treated with aggressive management, including methylene blue, ascorbic acid, and transfusion.
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