Successful Treatment of Dapsone Induced Methemoglobinemia with Ascorbic Acid: Two Case Reports

Acute dapsone poisoning is uncommon in childhood. The most frequent side effects are dose-related methemoglobinemia and hemolytic anemia, and rarely, can cause an idiosyncratic reaction, called dapsone hypersensitivity syndrome (DHS). Methemoglobinemia is a potentially life-threatening disorder characterized by the presence of >1% methemoglobin (metHb) in the blood. Symptoms produced depends upon methemoglobin levels. Methylene blue (MB) is the mainstay of treatment in severe cases. Other modalities used in less severe cases are activated charcoal and ascorbic acid. We hereby report two pediatric cases of accidental dapsone poisoning induced methemoglobinemia with severe symptoms, treated successfully with supportive therapy and ascorbic acid.