A Chest Pain Conundrum: Dapsone-Induced Methemoglobinemia in a Heart Transplant Patient

Kristina Akopyan; Konstantin Golubykh; Jared Freitas; Borna Mehrad

doi:10.7759/cureus.46690

A Chest Pain Conundrum: Dapsone-Induced Methemoglobinemia in a Heart Transplant Patient

Cureus. 2023 Oct 8;15(10):e46690. doi: 10.7759/cureus.46690. eCollection 2023 Oct.

Authors

Kristina Akopyan¹, Konstantin Golubykh², Jared Freitas³, Borna Mehrad⁴

Affiliations

¹ Internal Medicine, University of Florida, Gainesville, USA.
² Internal Medicine, University of Pittsburgh Medical Center, Harrisburg, USA.
³ Pulmonology and Critical Care, University of Florida, Gainesville, USA.
⁴ Pulmonary and Critical Care Medicine, University of Florida, Gainesville, USA.

Abstract

We present the case of a 39-year-old male with a past medical history of orthotopic heart transplantation who presented with chest pain and dyspnea on exertion. He was diagnosed with dapsone-induced methemoglobinemia toward the end of his hospital course, and his condition clinically improved with the discontinuation of the offending agent. This case highlights the importance of medication review and history-taking. Clinicians should be mindful of dapsone-induced methemoglobinemia, especially when encountering patients with dyspnea and a history of dapsone intake.

Keywords: cytochrome b5 reductase; dapsone-induced methemoglobinemia; methylene blue treatment; refractory hypoxemia; saturation gap.

Publication types

Case Reports