{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T21:33:55Z","timestamp":1781991235344,"version":"3.54.5"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,11,12]],"date-time":"2013-11-12T00:00:00Z","timestamp":1384214400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>After an outbreak of <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>neumocystis<\/jats:italic> pneumonia (<jats:styled-content style=\"fixed-case\">PCP<\/jats:styled-content>) in our nephrology unit, dapsone was used as the second\u2010line chemoprophylactic agent. Dapsone is the most common cause of drug\u2010induced methemoglobinemia (<jats:styled-content style=\"fixed-case\">MH<\/jats:styled-content>b). Its prevalence is poorly described in the renal transplant population. Because dapsone is excreted by the kidneys, we hypothesized that the rate of <jats:styled-content style=\"fixed-case\">MH<\/jats:styled-content>b in these patients would be higher than previously reported. We aimed to describe the demographics, risk factors, and presenting features of <jats:styled-content style=\"fixed-case\">MH<\/jats:styled-content>b in these renal transplant patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010six transplant recipients commenced on dapsone for chemoprophylaxis against <jats:styled-content style=\"fixed-case\">PCP<\/jats:styled-content> from <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>ebruary to <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>eptember 2011. All patients had normal glucose\u20106\u2010phosphate dehydrogenase levels before treatment. Characteristics of patients with <jats:styled-content style=\"fixed-case\">MH<\/jats:styled-content>b were compared with those of the rest of the cohort to determine potential risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve (46%) patients developed <jats:styled-content style=\"fixed-case\">MH<\/jats:styled-content>b (levels 6.4\u00a0\u00b1\u00a04.1%). Six (50%) of the patients with <jats:styled-content style=\"fixed-case\">MH<\/jats:styled-content>b were asymptomatic on presentation. Cases had a mean drop in hemoglobin of 19\u00a0\u00b1\u00a07%. <jats:styled-content style=\"fixed-case\">MH<\/jats:styled-content>b led to five admissions (median length of stay 5\u00a0days, range 1\u201310\u00a0days). <jats:styled-content style=\"fixed-case\">MH<\/jats:styled-content>b level showed a strong correlation with the length of stay (correlation coefficient 0.762, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the highest reported prevalence of <jats:styled-content style=\"fixed-case\">MH<\/jats:styled-content>b, to our knowledge, in patients receiving dapsone, and its use led to significant hospitalization in this population. This study raises concerns about the use of dapsone as chemoprophylaxis in renal transplant recipients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12161","type":"journal-article","created":{"date-parts":[[2013,11,12]],"date-time":"2013-11-12T07:52:52Z","timestamp":1384242772000},"page":"37-43","source":"Crossref","is-referenced-by-count":19,"title":["Dapsone\u2010induced methemoglobinemia in renal transplant recipients: more prevalent than previously thought"],"prefix":"10.1111","volume":"16","author":[{"given":"N.","family":"Mitsides","sequence":"first","affiliation":[{"name":"Nephrology Department Salford Royal NHS Foundation Trust Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Green","sequence":"additional","affiliation":[{"name":"Nephrology Department Salford Royal NHS Foundation Trust Salford 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