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Case Reports
. 2023 Oct 13:11:374-377.
doi: 10.1016/j.toxrep.2023.10.006. eCollection 2023 Dec.

Treatment of a life-threatening dapsone intoxication

M H Veerman  1 , T van Gelder  1 , R Sneijder  2 , C Bethlehem  1
Affiliations
Case Reports

Treatment of a life-threatening dapsone intoxication

M H Veerman et al. Toxicol Rep. .

Abstract

The case report describes a case of a severe dapsone (more than 200 tablets dapsone 100 mg) and mild methotrexate intoxication (10 tablets methotrexate 10 mg) as an attempt to commit suicide, resulting in severe cyanosis with elevation in methemoglobin concentration, treated with methylene blue, ascorbic acid, folinic acid, multidose activated charcoal and hemodialysis. Measurements of blood gases, dapsone and methotrexate levels were performed. Furthermore a hepatitis, pulmonary artery thrombus and a strange taste sensation were diagnosed, probably related to dapsone. The patient recovered and was discharged from hospital after five days. Acute intoxication from excessive dapsone intake is uncommon and clear treatment guidelines are lacking. We here report the treatment modalities as a result of a dapsone intoxication, including the effects on the overall condition of the patient.

Keywords: Dapsone; Hepatitis; Methemoglobinemia; Methotrexate; Pharmacokinetics; Poisoning; Toxicology.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Changes in liver enzymes over time.
Fig. 2
Fig. 2
Flowchart treatment dapsone intoxication.
See this image and copyright information in PMC

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