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Journal of The Korean Society of Emergency Medicine 2023;34(4): 379-382. |
| A case of acute kidney injury caused by dapsone-induced methemoglobinemia in a patient with chronic kidney disease |
Minsoo Kim1
, Su Ik Kim1
, Jeong Ryul Jo2
, Ju Hwan Oh2
, A Young Cho2
, Kwang Young Lee2
, In O Sun2
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1Department of Emergency Medicine, Presbyterian Medical Center, Jeonju, Korea
2Nephrology Division, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea |
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Received: November 1, 2022; Revised: February 17, 2023 Accepted: June 2, 2023. Published online: August 31, 2023. |
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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. |
| Key words:
Kidney; Methemoglobinemia; Renal insufficiency; Hypoxia; Hemoglobins |
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