A Curious Case of Palpitation in a Leprosy Patient with Low Grade Methemoglobinemia

Abstract

Dapsone is fairly a common drug in the armamentarium of a dermatologist with varied approved and ever-increasing latitude of novel indications. Methemoglobinemia is a known hematologic adverse effect with protean clinical manifestations depending on percentage of hemoglobin involved. We report one such case of Hansen's disease on multi drug therapy (MDT) and oral steroids who reported with an episode of sudden-onset palpitation.

Dapsone‐induced methaemoglobinaemia in leprosy: a close mimic of ‘happy hypoxia’ in the COVID‐19 pandemic

“…Tripathi, 1 A.R. Singh, 2, * R. Kapoor, 3 A. Sinha, 4 S. Ghosh, 2 K. Kaur, 5 D. Pokhariya, 6 S. Maity, 7 A. Tapadar, 2 A. Chandra 2…”

“…2 Moreover, allelic variations within IFN-pathway-genes can be found in those autoimmune diseases. 3 The first cases of new autoimmune phenomena related to Covid-19 were found with some delay after the outbreak of the pandemic. With a new awareness for possible induction of autoimmune-mediated phenomena associated with SARS-CoV-2 infection, the topic gained attention.…”

“…Important clues to diagnosis are hypoxia which is refractory to oxygen supplementation and presence of chocolate-coloured blood. 2,3 Treatment ranges from simply stopping the offending drug in asymptomatic cases to methylene blue for symptomatic cases. Other options include high-dose ascorbic acid, exchange transfusion and hyperbaric oxygen therapy.…”