Intensive Care Unit, Sanatorio Franchin, Buenos Aires, Argentina.
Intensive Care Unit, Sanatorio Franchin, Buenos Aires, Argentina.
Am J Emerg Med. 2020 Oct;38(10):2246.e1-2246.e2. doi: 10.1016/j.ajem.2020.05.056. Epub 2020 May 23.
Dapsone intoxication can be a life-threatening condition due its enterohepatic recirculation pharmacokinetics, and therefore, persistent methemoglobinemia development. We describe a case of a 17-year-old girl who was admitted 4 h after ingesting 5 g of dapsone. She presented methemoglobinemia (39%) and showed clinical signs of toxicity (cyanosis and altered mental status) despite mechanical ventilation. Multiple activated charcoal dosis and methylene blue infusions were performed. Notwithstanding initial improvement, a pattern of peaks and valleys was observed in serial methemoglobinemia measurements, with cyclic states of hypoxemia. On account of enterohepatic recirculation pharmacokinetics, clearance was enhanced by whole bowel irrigation. After 7 days of hospitalization, she was discharged in good general condition.
由于其肠肝循环药代动力学，导致持续性高铁血红蛋白血症的发展，因此，对氨苯砜中毒可能是一种危及生命的情况。我们描述了一例 17 岁女孩的病例，她在摄入 5 克对氨苯砜后 4 小时入院。尽管进行了机械通气，但她仍出现高铁血红蛋白血症（39%）和中毒的临床体征（发绀和意识状态改变）。多次给予活性炭剂量和亚甲蓝输注。尽管最初有所改善，但在连续的高铁血红蛋白血症测量中观察到了一个峰值和谷值的模式，伴有周期性的低氧血症。由于肠肝循环药代动力学，全肠灌洗增强了清除率。住院 7 天后，她情况良好出院。
