Dapsona ba�l� geli�en methomoglobinemide metilen mavisi ve hiperbarik oksijen tedavisi

Kurto�lu �elik, G�lhan; K�dak �zkaya, Selda; G�rmeli Kurt, Nazl�

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Ankara Medical Journal Dapsona ba�l� geli�en methomoglobinemide metilen mavisi ve hiperbarik oksijen tedavisi [Ankara Med J]

Ankara Med J. 2021; 21(1): 184-189 | DOI: 10.5505/amj.2021.33340

Dapsona ba�l� geli�en methomoglobinemide metilen mavisi ve hiperbarik oksijen tedavisi

G�lhan Kurto�lu �elik¹, Selda K�dak �zkaya², Nazl� G�rmeli Kurt¹
¹Ankara �ehir Hastanesi
²��rnak Devlet Hastanesi

Methemoglobinemi, kanda a��r� methemoglobin bulunmas� durumudur. Methemoglobinemi, siyanozun ay�r�c� tan�lar� aras�nda d��n�lmesi gereken, nadir g�r�len fakat klinik olarak �nemli bir durumdur, te�hisi h�zl� ve nispeten kolay bir prosed�rd�r. Acil hastalar�n tedavisinde; y�ksek ak�m O2 (HFO2) mevcut hemoglobinin doygunlu�unu sa�lamak i�in �nemlidir. Metilen mavisi, ila�lar�n ind�kledi�i semptomatik methemoglobinemi (g��s a�r�s�, nefes darl�� veya konf�zyon gibi hipoksi bulgular�) veya MetHb d�zeyleri>%20 olan asemptomatik hastalarda ilk se�enek tedavidir. 19 ya� kad�n hasta acil servisimize suisid ama�l� 2,5 gram dapson al�m� sonras� ba�vurdu�u ba�ka bir merkezden kan gaz�nda �l��len methomoglobinemi seviyesi %34 �l��lmesi �zerine getirildi. Y�ksek ak�m oksijen tedavisine yan�t vermeyen hastaya hiperbarik oksijen tedavisi 90 dakika s�reyle yap�ld�. Bu vaka sunumunda, standart metilen mavisi tedavisine yan�t vermeyen hipoksik ve siyanozlu methemoglobinemi hastas� anlatmak istedik.

Anahtar Kelimeler: Methemoglobinemi, metilen mavisi, siyanoz.

Methylene blue and hyperbaric oxygen treatment in dapson-induced methemoglobinemia

G�lhan Kurto�lu �elik¹, Selda K�dak �zkaya², Nazl� G�rmeli Kurt¹
¹Ankara City Hospital
²��rnak State Hospital

Methemoglobinemia is the presence of excessive methemoglobin in the blood. Methemoglobinemia is a rare but clinically important condition that should be considered among the differential diagnoses of cyanosis. It is a fast and relatively easy-to-diagnose procedure. In the treatment of emergency patients; high current O2 (HFO2) is important to ensure saturation of available hemoglobin. Methylene blue is the first-line treatment in asymptomatic patients with symptomatic methemoglobinemia (signs of hypoxia such as chest pain, shortness of breath, or confusion) or with MetHb levels> 20%. A 19-year-old female patient was brought to our emergency department after taking 2.5 grams of dapsone for suicide purposes from another center when the level of methemoglobinemia measured in blood gas was measured as 34%. Hyperbaric oxygen therapy was applied for 90 minutes to the patient who did not respond to high flow oxygen therapy. In this case report, we wanted to describe a patient with hypoxic and cyanotic methemoglobinemia who did not respond to standard methylene blue therapy.

Keywords: Methemoglobinemia, methylene blue, cyanosis.

Sorumlu Yazar: G�lhan Kurto�lu �elik, T�rkiye
Makale Dili: T�rk�e

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