%0 Journal Article
%T The mystery of ¡®saturation gap¡¯: a case of dapsone-induced methaemoglobinemia in a pregnant mother with leprosy
%A Andy Sing Ong Tang
%A Lee Ping Chew
%A Pubalan Muniandy
%A Siaw Tze Yeo
%A Wee Meng Kho
%A Yeon Chiat Teh
%J Archive of "Oxford Medical Case Reports".
%D 2019
%R 10.1093/omcr/omy111
%X Limited data regarding methemoglobinemia in pregnancy, particularly secondary to dapsone is available up to date. We report a case of dapsone-induced methemoglobinemia in a pregnant mother with multibacillary leprosy who presented with fever, productive cough and cyanosis of 2 days duration 2 weeks after multidrug therapy was commenced. On examination, she had central cyanosis with low oxygen saturation (SpO2 = 84¨C88%). Arterial blood gas analysis showed PO2 of 111 mmHg and SO2 of 98 mmHg. Patient was administered 100% oxygen inhalation, but there was no improvement in cyanosis. Vitamin C (1000 mg/day) was prescribed. Dapsone was replaced by ofloxacin 200 mg twice daily. There was a gradual increase in SpO2 level. She delivered a healthy baby. In conclusion, clinicians should be aware of the side effects of dapsone and know how to promptly manage any undesirable events. Ofloxacin is a safe and feasible alternative in replacement of dapsone in pregnancy
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345088/