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British Journal of Anaesthesia, 2001, Vol. 86, No. 2 278-280
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Unexplained acute severe methaemoglobinaemia in a young adult

M. Falkenhahn1, S. Kannan*,1 and M. O’Kane2

1Departments of Anaesthetics and 2Clinical Chemistry, Altnagelvin Hospital, Glenshane Road, Londonderry BT47 1SB, UK*Corresponding author: Department of Anaesthetics, Queen Elizabeth Hospital, Metchley Park Road, Edgbaston, Birmingham B15 2TH, UK

This report describes the case of an otherwise healthy young adult female, who presented with a 12-h history of progressive bluish discolouration of lips and limbs. She denied ingesting or inhaling any drug or substance. A high PaO2 in the presence of ‘cyanosis’ and ‘dark blood’ led to suspicion of methaemoglobinaemia. Co-oximetry revealed the methaemoglobin level to be 47%. A urinary screen for drugs of abuse was negative and blood methaemoglobin reductase activity was within the normal range. The aetiology was traced to dapsone detected in the urine by gas chromatography/mass spectrometry. The therapeutic and diagnostic approach in such patients is discussed.

Br J Anaesth 2001; 86: 278–80


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