Park Sin-Youl, Lee Kyung-Woo, Kang Tae-Sin
Department of Emergency Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
Department of Emergency Medicine, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea.
Am J Emerg Med. 2014 Jun;32(6):684.e1-3. doi: 10.1016/j.ajem.2013.11.036. Epub 2013 Nov 26.
Methylene blue is the first-choice treatment of methemoglobinemia, but it is not readily available in most Korean emergency departments because of an import suspension. An 84-year-old woman with dapsone-induced massive methemoglobinemia visited our emergency department for unclear mentality and cyanosis. Because methylene blue was not available, we intravenously administrated vitamin C (VC) for symptomatic methemoglobinemia, although VC is not a universally accepted treatment. Vitamin C (10 g intravenously) administered 6 hourly successfully treated the dapsone-induced methemoglobinemia and did not adversely affect renal functions. Thus,we recommend that if methylene blue is unavailable, 6 hourly intravenous administrations of 10 g of VC should be considered for dapsone-induced methemoglobinemia.
亚甲蓝是治疗高铁血红蛋白血症的首选药物，但由于进口暂停，在韩国大多数急诊科难以获得。一名84岁因服用氨苯砜导致大量高铁血红蛋白血症的女性因意识不清和发绀前来我院急诊科就诊。由于没有亚甲蓝，我们对有症状的高铁血红蛋白血症静脉注射了维生素C（VC），尽管VC并非普遍认可的治疗方法。每6小时静脉注射10g维生素C成功治疗了氨苯砜引起的高铁血红蛋白血症，且未对肾功能产生不利影响。因此，我们建议，如果没有亚甲蓝，对于氨苯砜引起的高铁血红蛋白血症，应考虑每6小时静脉注射10g维生素C。
