Dapsone Hypersensitivity Syndrome (DHS): A Detrimental Effect of Dapsone? A Case Report

Abstract

Background: Dapsone is a sulfone derived drug used in the treatment of leprosy and several chronic inflammatory dermatological diseases. Dapsone Hypersensitivity Syndrome (DHS) is characterized by fever, hepatitis, generalized exfoliative dermatitis and lymphadenopathy. It is rare and potentially fatal. Case Report: We present a case report of a 52 years old female with a recent history of antecedent dapsone exposure of 100 mg daily for 2 weeks. She developed fever 10 days after exposure to dapsone therapy and was treated in various primary and tertiary centers for features of sepsis. When she presented to us, clinical features of multi-organ dysfunction and intractable sepsis was evident. She was successfully managed with intravenous corticosteroids and other supportive therapy. This case of DHS is unique due to pulmonary, hepatic and colonic involvement in addition to secondary bacterial and fungal infection, which is associated with an increased risk of mortality. Conclusion: As dapsone is mainstay in the treatment several infections and inflammatory conditions, further research is needed to characterize markers to diagnose DHS and to develop screening policies prior to initiation of dapsone therapy.

Functional and structural characteristics of HLA-B*13:01-mediated specific T cells reaction in dapsone-induced drug hypersensitivity

“…The HLA-B*13:01 allele has been identified as an important risk allele for SCARs induced by a number of drugs, including dapsone (diaminodiphenyl sulfone, DDS) [18][19][20][21][22][23][24]. DDS-induced hypersensitivity syndrome (DDS-DIHS) is one of the major causes of mortality amongst leprosy patients possessing the HLA-B*13:01 allele (i.e., about 2% of leprosy patients with DDS therapy, mortality rate 12.5%) [25][26][27].…”

Dapsone Induced Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) Syndrome - A Case Report

“…The prevalence of DHS among Chinese patients was 1.5% and 2% in Nepal, with a fatality rate of 9.6%. HLA-B*13:01 allele was considered an important genetic marker among high-risk populations [13,16,17]. It was most surprising that HLA-B13:01 exhibited a strong association with DIHS attributable to dapsone (dapsone hypersensitivity) but HLA-B13:02 did not [13].…”

Dapsone hypersensitivity syndrome: a case in rural area of Indonesia

“…This syndrome is also more commonly found in patients receiving a multi-drug therapy (MDT). [1][2][3] This syndrome is caused by adverse reaction of the medications characterized by the clinical triad of fever, itch, and systemic involvement (usually the hepatobiliary and hematological system), which can lead to organ system dysfunction and ultimately death. Up to this date, there are no supporting examinations to predict the risk of dapsone hypersensitivity syndrome.…”