Role of ascorbic acid in the treatment of methemoglobinemia

We read with great pleasure the recent article wrote by Toker et al in your esteemed journal.1 We would like to share our experience of two similar cases on “Role of ascorbic acid in treating methemoglobinemia”. A-45 year old middle aged gentleman was diagnosed as a case of acute ITP 6 months back when he was evaluated for symptoms of epistaxis and melena. He was treated with pulse doses of methylprednisolone (1000 mg for 3 days) followed by oral steroid therapy (1 mg/kg). He responded dramatically with complete resolution of symptoms and recovery of platelet count. Later, steroids were tapered on follow up and he became drug free. Three months after completion of therapy, he relapsed with complaints of gum bleed and petechial spots all over the body. Laboratory evaluation revealed severe thrombocytopenia (6 × 106/L). In view of his past treatment history and good response to steroid therapy, he was again started on oral steroid therapy (1 mg/kg). However, unlike the previous episode there was a stunted response to steroids this time and hence alternative medications were considered. ....