Abid Rusul Mahdi, Fendi Muthanna Thiab, Hashim Hashim Talib, Hussein Zainab Ali, Basalilah Ashraf Fhed Mohammed
Al-Nassiryah Teaching Hospital, Nassiryah, Iraq.
University of Thi Qar, College of Medicine, Nassiryah, Iraq.
Medicine (Baltimore). 2025 Jul 25;104(30):e41991. doi: 10.1097/MD.0000000000041991.
Acquired methemoglobinemia, a rare condition, occurs due to the presence of elevated methemoglobin levels in the blood, leading to tissue hypoxia. Dapsone, commonly used in dermatological conditions, can induce methemoglobinemia. This study is important as acquired methemoglobinemia, especially induced by dapsone, is a rare but life-threatening condition. The aim of this case report is to highlight its clinical presentation and the importance of prompt diagnosis and treatment.
A previously healthy 16-year-old female presented with acute cyanosis, dyspnea, palpitations, and headache 1 day after initiating dapsone 200 mg for acne. On examination, she was hemodynamically stable but had central and peripheral cyanosis. Oxygen saturation was 83% despite supplemental oxygen. Cardiopulmonary and neurological examinations were unremarkable.
Laboratory tests, including complete blood count, renal function tests, liver function tests, and electrocardiography, were within normal limits. However, arterial blood gas analysis revealed a methemoglobin level of 17%, confirming dapsone-induced methemoglobinemia.
The offending agent was discontinued, and supportive oxygen therapy was initiated.
Within 6 hours, the methemoglobin level decreased to 3%, with complete resolution of symptoms. The patient was discharged home with advice to avoid dapsone in the future.
This case focused on the importance of methemoglobinemia in a differential diagnosis for a patient with a history of drug use, including dapsone, who exhibits symptoms and cyanosis suggestive of tissue hypoxia. In such a patient, prompt care and appropriate action will have a favorable prognosis.
获得性高铁血红蛋白血症是一种罕见病症，由于血液中高铁血红蛋白水平升高而发生，导致组织缺氧。常用于皮肤病治疗的氨苯砜可诱发高铁血红蛋白血症。这项研究很重要，因为获得性高铁血红蛋白血症，尤其是由氨苯砜诱发的，是一种罕见但危及生命的病症。本病例报告的目的是突出其临床表现以及及时诊断和治疗的重要性。
一名既往健康的16岁女性在开始服用200毫克氨苯砜治疗痤疮1天后出现急性发绀、呼吸困难、心悸和头痛。检查时，她血流动力学稳定，但有中央和外周发绀。尽管给予了补充氧气，氧饱和度仍为83%。心肺和神经系统检查无异常。
包括全血细胞计数、肾功能检查、肝功能检查和心电图在内的实验室检查均在正常范围内。然而，动脉血气分析显示高铁血红蛋白水平为17%，证实为氨苯砜诱发的高铁血红蛋白血症。
停用致病药物，并开始给予支持性氧疗。
6小时内，高铁血红蛋白水平降至3%，症状完全缓解。患者出院回家，并被建议今后避免使用氨苯砜。
本病例强调了高铁血红蛋白血症在有用药史（包括氨苯砜）且出现提示组织缺氧症状和发绀的患者鉴别诊断中的重要性。对于此类患者，及时治疗和采取适当措施将有良好的预后。
