Metahemoglobinemia, una entidad de diagnóstico complejo. Reporte de un caso

Methemoglobinemia is a rare condition with serious consequences if not diagnosed. We report the case of a 64-year-old woman with a history of allergy to sulfa drugs and a recent diagnosis of a small vessel vasculitis (ANCA-p) who started induction therapy with corticosteroids and rituximab. Due to t...

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Autores principales:	Sepúlveda,Rodrigo A., Barnafi,Esteban, Rojas,Vicente, Jara,Aquiles
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2020
Materias:	Blood Gas Analysis Dapsone Methemoglobinemia Methylene Blue
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020001201838
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spelling	oai:scielo:S0034-988720200012018382021-04-04Metahemoglobinemia, una entidad de diagnóstico complejo. Reporte de un casoSepúlveda,Rodrigo A.Barnafi,EstebanRojas,VicenteJara,Aquiles Blood Gas Analysis Dapsone Methemoglobinemia Methylene Blue Methemoglobinemia is a rare condition with serious consequences if not diagnosed. We report the case of a 64-year-old woman with a history of allergy to sulfa drugs and a recent diagnosis of a small vessel vasculitis (ANCA-p) who started induction therapy with corticosteroids and rituximab. Due to the need for infectious prophylaxis, and considering her history, dapsone was administered instead of cotrimoxazole after ruling out glucose-6-phosphate dehydrogenase deficiency. During the admission to the hospital for her second dose of rituximab, and while being asymptomatic, she persistently presented a pulse oximetry ≪ 90% despite the administration of O2. Therefore, the infusion was postponed to study the patient. The arterial gasometric study by direct potentiometry revealed an O2 saturation of 98%, with a saturation gap > 5%. Considering the use of dapsone, a methemoglobinemia was suspected and confirmed by co-oximetry (methemoglobinemia 9%). Dapsone was suspended and one week later, her methemoglobinemia was absent.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.148 n.12 20202020-12-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020001201838es10.4067/S0034-98872020001201838
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Blood Gas Analysis Dapsone Methemoglobinemia Methylene Blue
spellingShingle	Blood Gas Analysis Dapsone Methemoglobinemia Methylene Blue Sepúlveda,Rodrigo A. Barnafi,Esteban Rojas,Vicente Jara,Aquiles Metahemoglobinemia, una entidad de diagnóstico complejo. Reporte de un caso
description	Methemoglobinemia is a rare condition with serious consequences if not diagnosed. We report the case of a 64-year-old woman with a history of allergy to sulfa drugs and a recent diagnosis of a small vessel vasculitis (ANCA-p) who started induction therapy with corticosteroids and rituximab. Due to the need for infectious prophylaxis, and considering her history, dapsone was administered instead of cotrimoxazole after ruling out glucose-6-phosphate dehydrogenase deficiency. During the admission to the hospital for her second dose of rituximab, and while being asymptomatic, she persistently presented a pulse oximetry ≪ 90% despite the administration of O2. Therefore, the infusion was postponed to study the patient. The arterial gasometric study by direct potentiometry revealed an O2 saturation of 98%, with a saturation gap > 5%. Considering the use of dapsone, a methemoglobinemia was suspected and confirmed by co-oximetry (methemoglobinemia 9%). Dapsone was suspended and one week later, her methemoglobinemia was absent.
author	Sepúlveda,Rodrigo A. Barnafi,Esteban Rojas,Vicente Jara,Aquiles
author_facet	Sepúlveda,Rodrigo A. Barnafi,Esteban Rojas,Vicente Jara,Aquiles
author_sort	Sepúlveda,Rodrigo A.
title	Metahemoglobinemia, una entidad de diagnóstico complejo. Reporte de un caso
title_short	Metahemoglobinemia, una entidad de diagnóstico complejo. Reporte de un caso
title_full	Metahemoglobinemia, una entidad de diagnóstico complejo. Reporte de un caso
title_fullStr	Metahemoglobinemia, una entidad de diagnóstico complejo. Reporte de un caso
title_full_unstemmed	Metahemoglobinemia, una entidad de diagnóstico complejo. Reporte de un caso
title_sort	metahemoglobinemia, una entidad de diagnóstico complejo. reporte de un caso
publisher	Sociedad Médica de Santiago
publishDate	2020
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020001201838
work_keys_str_mv	AT sepulvedarodrigoa metahemoglobinemiaunaentidaddediagnosticocomplejoreportedeuncaso AT barnafiesteban metahemoglobinemiaunaentidaddediagnosticocomplejoreportedeuncaso AT rojasvicente metahemoglobinemiaunaentidaddediagnosticocomplejoreportedeuncaso AT jaraaquiles metahemoglobinemiaunaentidaddediagnosticocomplejoreportedeuncaso
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Metahemoglobinemia, una entidad de diagnóstico complejo. Reporte de un caso

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