@article{32855,
  author = {Tang A and Yeo ST and Teh YC and Kho WM and Chew L and Muniandy P},
  title = {The mystery of 'saturation gap': a case of dapsone-induced methaemoglobinemia in a pregnant mother with leprosy.},
  abstract = {<p>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 (SpO = 84-88%). Arterial blood gas analysis showed PO of 111 mmHg and SO 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 SpO 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.</p>
},
  year = {2019},
  journal = {Oxford medical case reports},
  volume = {2019},
  pages = {omy111},
  issn = {2053-8855},
  url = {https://academic.oup.com/omcr/article/2019/1/omy111/5299972},
  doi = {10.1093/omcr/omy111},
  language = {eng},
}