Dapsone hypersensitivity. The sulfone syndrome revisited

Tomecki, K. J.

doi:10.1001/archderm.117.1.38

Cited by 32 publications

(21 citation statements)

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“…Later reports consider that the syndrome is due to an idiosyncratic hypersensitivity reaction to dapsone. I , 4,6,9 Eight of the 20 patients reported since 1949 received dapsone for conditions other than leprosy, and, including the 2 present cases, only 36% developed the complete clinical complex of rash, fe ver, jaundice and lymphadenopathy, which is in keeping with the observation of one study1 6 that the fu ll syndrome is rare. Where it occurred, fever was generally high and lasted for one week or more.…”

Section: Commentsupporting

confidence: 85%

Dapsone syndrome occurring in two brothers

Jamrozik¹

1986

Leprosy Review

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Section: Commentsupporting

confidence: 85%

Dapsone syndrome occurring in two brothers

Jamrozik¹

1986

Leprosy Review

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“…The pathogenesis of the sulfone syndrome is not well established but seems to be related to a delayed hypersensitivity reaction with eosinophilia [1,2]. Hepatic injury occurs in the majority of patients and can be both cholestatic and hepatocellular in nature.…”

Section: Discussionmentioning

confidence: 99%

“…It has recently been studied for PCP prophylaxis in the hematopoietic stem cell transplant (HSCT) setting by Boeckh et al in patients who could not tolerate trimethoprim-sulfamethoxazole (TMP-SMX) [1]. Dapsone is a diaminodiphenylsulfone with indications for the treatment of leprosy, dermatitis herpetiformis and as a second line agent in the treatment and prevention against Pneumocystis carinii pneumonia (PCP) [2]. With the increase in number of immunocompromised patients, dapsone use for PCP prophylaxis is on the rise [2].…”

Section: Introductionmentioning

confidence: 99%

“…Dapsone is a diaminodiphenylsulfone with indications for the treatment of leprosy, dermatitis herpetiformis and as a second line agent in the treatment and prevention against Pneumocystis carinii pneumonia (PCP) [2]. With the increase in number of immunocompromised patients, dapsone use for PCP prophylaxis is on the rise [2]. Dapsone has good oral bioavailability and passes through the liver via enterohepatic circulation [3].…”

Section: Introductionmentioning

confidence: 99%

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The sulfone syndrome secondary to dapsone prophylaxis in a patient undergoing unrelated hematopoietic stem cell transplantation

Abidi

Kozlowski

Ibrahim

et al. 2006

Hematological Oncology

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Dapsone is commonly used for pneumocystis carinii pneumonia (PCP) prophylaxis in immunocompromised patients. It has been used as an alternative therapy in the hematopoietic stem cell transplant (HSCT) setting in patients who can't tolerate trimethoprim-sulfamethoxazole. The Sulfone syndrome is not a well-known sequela of dapsone therapy and occurs at various doses, ranging from 50-300 mg/d. In all cases the syndrome occurs within 2 months of initiating therapy. Its clinical manifestations include: fever, methemoglobinemia, hemolytic anemia, exfoliative dermatitis and transaminits. A 51-year old female underwent a matched unrelated hematopoiectic stem cell transplant for acute mylogenous leukemia. Dapsone therapy was initiated on day +28 at a dose of 100 mg/day for PCP prophylaxis secondary to the patient's history of a sulfonamide allergy. On day +59, one month after initiation of therapy she developed hepatitis, hemolytic anemia, fever and methemoglobinemia of 8%. She was transferred to the intensive care unit and subsequently developed an exfoliative dermatitis. We conclude that the clinical presentation of this patient after HSCT on dapsone therapy coincide with the sulfone syndrome not previously described in a patients after HSCT.

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“…It is antibacterial drug used in the treatment of Mycobacterium leprae infection (leprosy), and malaria [1, 2]. It is official in BP and USP [3, 4]:…”

Section: Introductionmentioning

confidence: 99%

Thermoanalytical Investigation of Some Sulfone-Containing Drugs

Salama

Ries

Toubar

et al. 2012

Journal of Analytical Methods in Chemistry

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The thermal behavior of some sulfone-containing drugs, namely, dapsone (DDS), dimethylsulfone (MSM), and topiramate (TOP) in drug substances, and products were investigated using different thermal techniques. These include thermogravimetry (TGA), derivative thermogravimetry (DTG), differential thermal analysis (DTA), and differential scanning calorimetry (DSC). The thermogravimetric data allowed the determination of the kinetic parameters: activation energy (Ea), frequency factor (A), and reaction order (n). The thermal degradation of dapsone and topiramate was followed a first-order kinetic behavior. The calculated data evidenced a zero-order kinetic for dimethylsulfone. The relative thermal stabilities of the studied drugs have been evaluated and follow the order DDS > TOP > MSM. The purity was determined using DSC for the studied compounds, in drug substances and products. The results were in agreement with the recommended pharmacopoeia and manufacturer methods. DSC curves obtained from the tablets suggest compatibility between the drugs, excipients and/or coformulated drugs. The fragmentation pathway of dapsone with mass spectrometry was taken as example, to correlate the thermal decomposition with the resulted MS-EI. The decomposition modes were investigated, and the possible fragmentation pathways were suggested by mass spectrometry.

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Dapsone hypersensitivity. The sulfone syndrome revisited

Cited by 32 publications

References 0 publications

Dapsone syndrome occurring in two brothers

Dapsone syndrome occurring in two brothers

The sulfone syndrome secondary to dapsone prophylaxis in a patient undergoing unrelated hematopoietic stem cell transplantation

Thermoanalytical Investigation of Some Sulfone-Containing Drugs

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