01498nas a2200193   4500000000100000008004100001100001100042700001100053700001100064700001100075700001100086700001500097245011700112856006400229300001100293490000900304520097700313022001401290       2019                            d1 aTang A1 aYeo ST1 aTeh YC1 aKho WM1 aChew L1 aMuniandy P00aThe mystery of 'saturation gap': a case of dapsone-induced methaemoglobinemia in a pregnant mother with leprosy.  uhttps://academic.oup.com/omcr/article/2019/1/omy111/5299972  aomy1110 v20193 a<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>
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