Dapsone induced methemoglobinemia : Intermittent vs continuous intravenous methylene blue therapy

Indian J Pediatr. 2008 Mar;75(3):245-7. doi: 10.1007/s12098-008-0053-2.

Abstract

Objective: The study compares the decline in blood methemoglobin (MetHb) level in children of dapsone intoxication treated with intermittent and continuous methylene blue therapy.

Methods: Eleven children with history of accidental dapsone ingestion and suggestive clinical features of dapsone intoxication were studied. Patients were randomized into two groups: Gr I (n=5) received intermittent methylene blue therapy, while Gr II (N=6) as continuous infusion. The dose of methylene blue was same in both groups. MetHb level in blood was assessed by spectrophotometer at admission and thereafter 12hrly up to 72 hrs. The decline in MetHb was statistically analyzed with student t-test.

Results: Six patients had history of seizure and altered sensorium. Severe anemia was observed in 2 patients. The mean levels of MetHb in Gr II was statistically significant after 12, 24, 36, 48 and 72 hrs of methylene blue therapy as compared to Gr I.

Conclusion: Continuous I.V methylene blue therapy causes significant decline in MetHb level and is more effective in treatment of methemoglobinemia as compared to intermittent regimen.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anti-Infective Agents / poisoning*
  • Child, Preschool
  • Dapsone / poisoning*
  • Enzyme Inhibitors / administration & dosage*
  • Female
  • Humans
  • Infusions, Intravenous
  • Male
  • Methemoglobinemia / chemically induced*
  • Methemoglobinemia / drug therapy*
  • Methylene Blue / administration & dosage*

Substances

  • Anti-Infective Agents
  • Enzyme Inhibitors
  • Dapsone
  • Methylene Blue