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KMID : 0385920230340040379
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Journal of the Korean Society of Emergency Medicine
2023 Volume.34 No. 4 p.379 ~ p.382
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A case of acute kidney injury caused by dapsone-induced methemoglobinemia in a patient with chronic kidney diseas
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Kim Min-Soo
Kim Su-Ik
Jo Jeong-Ryul
Oh Ju-Hwan
Cho A-Young
Lee Kwang-Young
Sun In-O
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Abstract
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Methemoglobinemia (MetHb), which is characterized by an increased methemoglobin level, is a rare but potentially fatal disorder caused by congenital enzyme deficiencies or exposure to oxidizing agents, including dapsone. Elevation in the methemoglobin level impairs the oxygen-carrying capacity of hemoglobin, produces functional anemia, and induces tissue hypoxia. Such hypoxia results in microcirculation injury and hypoperfusion in the tissue and organs, including the kidney, and is a risk factor for acute kidney injury (AKI). This paper reports a case of AKI caused by dapsone-induced MetHb in a patient with chronic kidney disease, in which the patient ingested approximately 1,500 mg of dapsone in a suicide attempt, which was treated with aggressive management, including methylene blue, ascorbic acid, and transfusion.
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KEYWORD
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Kidney, Methemoglobinemia, Renal insufficiency, Hypoxia, Hemoglobins
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