Yonsei Med J.  1999 Aug;40(4):388-391. 10.3349/ymj.1999.40.4.388.

A case of methemoglobinemia after ingestion of an aphrodisiac, later proven as dapsone

• Lee SW
• Lee JY
• Lee KJ
• Kim M
• Kim MJ

• KMID: 711667
• DOI: http://doi.org/10.3349/ymj.1999.40.4.388

Abstract

Methemoglobin (MetHb) is an oxidation product of hemoglobin in which the sixth coordination position of ferric iron is bound to a water molecule or to a hydroxyl group. The most common cause of acquired MetHb-emia is accidental poisoning which usually is the result of ingestion of water containing nitrates or food containing nitrite, and sometimes the inhalation or ingestion of butyl or amyl nitrite used as an aphrodisiac. We herein report a case of MetHb-emia after ingestion of an aphrodisiac, later identified as dapsone by gas chromatograph/mass selective detector (GC/MSD). A 24-year old male was admitted due to cyanosis after ingestion of a drug purchased as an aphrodisiac. On arterial blood gas analysis, pH was 7.32, PaCO2 26.8 mmHg, PaO2 75.6 mmHg, and bicarbonate 13.9 mmol/L. Initial pulse oxymetry was 89%. With 3 liter of nasal oxygen supplement, oxygen saturation was increased to 90-92%, but cyanosis did not disappear. Despite continuous supplement of oxygen, cyanosis was not improved. On the fifth hospital day, MetHb was 24.9%. Methylene blue was administered (2 mg/kg intravenously) and the patient rapidly improved. We proved the composition of aphrodisiac as dapsone by the method of GC/MSD.

Keyword

Methemoglobinemia; dapsone; poisoning

MeSH Terms

Administration, Oral
Adult
Antidotes/therapeutic use
Aphrodisiacs/adverse effects*
Case Report
Cyanosis/drug therapy
Cyanosis/chemically induced
Cyanosis/blood
Dapsone/adverse effects*
Human
Male
Methemoglobinemia/drug therapy
Methemoglobinemia/chemically induced*
Methylene Blue/therapeutic use