DAPSONE INDUCED METHEMOGLOBINEMIA : AN UNCOMMON CAUSE OF HYPOXEMIA ( A CASE REPORT)

Dapsone is a drug commonly used as a second line therapy for various chronic inflammatory disorders. Out of various side effects associated,methemoglobinemia is a less commonly known adverse effect of dapsone.A patient diagnosed to have immune thombocytoepnia, received dapsone as a steroid sparing drug , who later got admitted in outside hospital for symptoms of breathlessness, fever.The patient was empirically treated with antibiotics , and later referred here for further management. Owing to the clinical and radiological disparity,patient was initially suspected and later diagnosed to have methemoglobinemia. Methemoglobinemia was confirmed by an arterial and venous blood gas sample. Patient was then treated with methylene blue,which led to a drastic improvement in her clinical condition.In a couple of days patient was discharged, and was followed by the hematology team for immune thrombocytopenia.The case highlights the importance for keeping a high suspicion for methemoglobinema in cases of hypoxemia and using ABG (arterial blood gas) as a tool for the diagnosis.