Dapsone-induced agranulocytosis: spontaneous reporting data

Cockburn, E.M.; Wood, Steve M; Waller, P.J.; Bleehen, S.S.

doi:10.1111/j.1365-2133.1993.tb00272.x

Cited by 14 publications

(3 citation statements)

References 3 publications

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“…Similarly, agranulocytosis was also reported in patients with giant cell (temporal) arteritis [13], dermatitis herpetiformis [11], granuloma annulare [14], and urticaria [15]. Several cases of dapsone-induced agranulocytosis, hemolytic anemia, neutropenia, thrombocytopenia, septic shock, Dapsone-induced agranulocytosis and hypersensitivity have also been described [6,[16][17][18][19][20][21]. Hemolytic anemia was reported in cases of dapsone overdose [22].…”

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confidence: 99%

Dapsone‐induced agranulocytosis—possible involvement of low‐activity N‐acetyltransferase 2

Potočnjak

Likić

Šimić

et al. 2017

Fundamemntal Clinical Pharma

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Dapsone-induced agranulocytosis is a rare but potentially fatal adverse drug reaction (ADR). A 45-year-old male Caucasian patient developed agranulocytosis caused by dapsone (diamino-diphenyl sulfone), which he was prescribed for leukocytoclastic vasculitis. Patient's treatment consisted of termination of dapsone, antibiotic therapy, and granulocyte colony-stimulating factor leading to prompt improvement of symptoms and normalization of laboratory blood values. Diagnostic evaluation revealed methemoglobinemia and excluded glucose-6-phosphate dehydrogenase deficiency. Pharmacogenetics testing showed that he was a carrier of NAT2 *5/*6 genotype, predisposing to low activity of the N-acetyltransferase 2 enzyme. This was the first and only ADR to dapsone reported in Croatia. In total, there have been 73 ADR to dapsone recorded worldwide, including only four cases of agranulocytosis.

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confidence: 99%

Dapsone‐induced agranulocytosis—possible involvement of low‐activity N‐acetyltransferase 2

Potočnjak

Likić

Šimić

et al. 2017

Fundamemntal Clinical Pharma

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“…Very rarely does agranulocytosis develop after more than 12 weeks of therapy. The average dose in reported cases was 100 mg/day; there is no evidence for dose dependency in this effect (69,70). Patients most often present with symptoms/signs of infection such as fever or pharyngitis.…”

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confidence: 99%

“…Agranulocytosis Agranulocytosis is one of the most serious idiosyncratic reactions to dapsone (69,70). The exact mechanism of the agranulocytosis is not known, however, several hypotheses have been proposed.…”

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confidence: 99%

Dapsone

Sago

Hall

2002

Dermatol Ther

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Dapsone and other sulfonamides have been used successfully in the treatment of patients with a variety of blistering skin diseases. The patients most likely to respond to dapsone therapy have a predominantly neutrophilic infiltrate in their skin. Therefore the blistering diseases with the most consistent responses to dapsone therapy include dermatitis herpetiformis and linear IgA disease. Dapsone's precise mechanism of action is unknown. In vitro studies have shown that dapsone can interfere with the production of and response to neutrophil chemoattractants and that it may impair the neutrophils' ability to localize to sites of inflammation and produce toxic oxygen intermediates. The safe use of dapsone requires an understanding of the pharmacology and adverse effects of the drug. Hemolytic anemia and methemoglobinemia are two of the dose‐related adverse effects. Agranulocytosis, motor neuropathy, and dapsone hypersensitivity syndrome are some of the severe idiosyncratic effects that can occur in patients treated with dapsone. Dapsone is an effective drug for the management of patients with some blistering disease, especially those with predominant neutrophilic infiltrates in the skin. Careful patient selection and close monitoring of patients during therapy with dapsone are critical elements in the safe and effective use of dapsone for patients with blistering skin diseases.

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Drug Reactions

Breathnach¹

2004

Rook's Textbook of Dermatology

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Dapsone-induced agranulocytosis: spontaneous reporting data

Cited by 14 publications

References 3 publications

Dapsone‐induced agranulocytosis—possible involvement of low‐activity N‐acetyltransferase 2

Dapsone‐induced agranulocytosis—possible involvement of low‐activity N‐acetyltransferase 2

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