Background:
@EN Methemoglobinemia (MetHb) induced by dapsone overdose is not uncommon in Korea, especially in rural area. For treatment of dapsone-induced methemoglobinemia, methylene blue(MB) and activated charcoal (AC) should be used. To date, no reports
have
compared the amount of MB used between MB alone with MB & alone with MB & AC combined group(MB+AC). And also between moderate (MetHb<35%) land severe (MetHb>35%) intoxicated group defined by initial MetHb level. Authors hypothesized that less
amount of
MB can be used if MB and AC was used together and larger amount of MB is necessary to reduce MetHb level to asymptomatic level in severely intoxicated group.
@ES Methods:
@EN From Jan 1990 to Dec 1996, a total of 54 patients who received treatment for dapsone intoxication were subject of study, The study was done retrospective chart analysis for initial MetHb level, total amount of MB and AC. Wilcoxon rank sum
test
and
Chi-sqiare test was used to compare the total dosage of MB used for each group. Linear regression analysis was used between initial MetHb and the total amount of MB. Results were considered statistically significant when P<0.05.
@ES Results:
@EN For MB alone and MB+AC group, the differences in total amount of MB used were statistically significant with mean dosage of 7.14±1.1mg/kg and 4.28±0.7mg/kg, respectively. And total amount of MB used between moderate and severe intoxicated
group,
the differences were statistically significant with mean dosage of 5.16±1.1mg/kg vs. 10.98±1.9mg/kg, respectively. There was significant correlation between initial MetHb level (X) and the amount of methylene blue (Y), Y=0.3X-2.42(r2=0.41,
p=0.0001)
in MB alone, Y=0.186X-1.95(r2=0.21, p=0.034) in MB+AC respectively.
@ES Conclusion:
@EN For methemoglobinemia induced by dapsone, total amount of MB can be reduced especially in severe intoxicated group if AC use was combined in treatment modality. There was significant correlationship between initial MetHb level and total
amount
of MB
used.
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