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Article in Japanese
A case of diaphenylsulfone-induced methemoglobinemia concurred with bronchial asthma
Maiko Asakumaa,d Masanori Yokobab,d Ken Katonoc,d Akira Takakurac,d Masato Katagirib,d Noriyuki Masudac,d
aKitasato University Graduate School of Medical Sciences
bClinical Physiology Laboratory, School of Allied Health Sciences, Kitasato University
cDepartment of Respiratory Medicine, School of Medicine, Kitasato University
dRespiratory Medicine, Kitasato University Hospital
A 50-year-old woman had her first episode of idiopathic thrombocytopenic purpura (ITP) at the age of 19. She was first treated with prednisolone (PSL); however, it was found to be ineffective. She was then treated with vincristine, immunoglobulin preparations, danazol, cyclosporine, and splenectomy for refractory ITP. Lastly, she was administered PSL and diaphenylsulfone (DDS). She had felt dyspnea at night, about one month before beginning to take DDS. Approximately 2 months after beginning to take DDS, she complained of dyspnea, orthopnea, and wheezing and was admitted to our hospital with a diagnosis of bronchial asthma. Oxygen therapy and PSL, aminophylline, and salbutamol inhalation were administered to the patient, but she still complained of dyspnea, and cyanosis and oxygen desaturation on the SpO2 profile were observed. After her platelet count had increased to sufficient levels, a blood gas analysis was performed. It revealed a difference between SpO2 (92%; O2 at 3 L/min) and SaO2 (97.6%) or PaO2 (110.5 Torr) with 4.0% of methemoglobinemia. We decided to discontinue DDS. Her symptoms and the difference between SpO2 and SaO2 improved immediately. Moreover, the methemoglobin level in the blood was reduced to a normal level. Respiratory physicians must be made aware that DDS can induce methemoglobinemia.
Methemoglobinemia Diaphenylsulfone Dapsone Ideopathic thrombocytopenic purpura
Received 23 May 2013 / Accepted 22 Aug 2013
AJRS, 3(1): 98-102, 2014