Drug reactions to the sulfones

Millikan, Larry E.

doi:10.1001/archderm.102.2.220

Cited by 16 publications

(6 citation statements)

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“…It may be caused by metabolites of dapsone forming haptens with the formation of anti‐dapsone antibodies (8). The exact incidence of DHS is not known, but it is reported to occur in less than 1% of patients treated with dapsone (9, 10). There has been an increased incidence of DHS in the past two decades worldwide.…”

Section: Discussionmentioning

confidence: 99%

Dapsone Hypersensitivity Syndrome: A Clinico-Epidemiological Review

Agrawal

Agarwalla

2005

The Journal of Dermatology

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Diaminodiphenyl sulphone (dapsone) is a drug of choice in the treatment of leprosy. It is also useful for the treatment of many neutrophilic and other dermatoses. Dapsone hypersensitivity syndrome is a rare but well recognized serious adverse effect characterized by fever, skin rashes, generalized lymphadenopathy, hepatitis, and hepato-splenomegaly. Twenty-six patients with dapsone hypersensitivity syndrome were studied for clinical profile, outcome, and prognosis. The male:female ratio was 2.2:1, and the mean age was 33.19 years (range 13 to 64 years). The interval between start of dapsone therapy and appearance of symptoms varied from 2-7 weeks (mean 29.82 days). Twenty-four patients received dapsone as a part of multi-drug therapy for leprosy; the other two patients received dapsone for lichen planus and acne vulgaris. Exfoliative dermatitis was the most common cutaneous manifestation followed by erythematous maculo-papular eruption and Stevens-Johnson syndrome-like lesion. The other common systemic manifestations were: fever (26 cases), itching (22 cases), lymphadenopathy (21 cases), jaundice (21 cases), pallor (20 cases), hepatomegaly (19 cases), and pedal edema (14 cases). Investigation profile revealed elevated levels of serum liver enzymes in 100% of patients, elevated erythrocyte sedimentation rate in 92.3%, raised bilirubin in 84.6%, leucocytosis in 69.23%, low hemoglobin (<9 gm/dl) in 46.15% and hypoproteinemia in 42.3%. Eosinophilia, hemolytic anemia, and reticulocytosis count were found in 4 patients each. All the patients had favorable outcomes except three who died due to hepatic failure. Medical personnel must be aware of this potentially fatal syndrome, because it can cause considerable morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Dapsone Hypersensitivity Syndrome: A Clinico-Epidemiological Review

Agrawal

Agarwalla

2005

The Journal of Dermatology

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“…717 The toxic effects of dapsone are varied and include hématologie, dermatologie, neurologic, renal, and gastroin¬ testinal aberrations.18,19 An unusual and potentially fatal hypersensitivity reaction, the "sulfone syndrome," has been described and consists of fever, malaise, hepatitis with hepatic necrosis, exfoliative dermatitis, lymphadenopathy, methemoglobinemia, and hemolytic anemia. 18 We report a case of dapsone-induced hypersensitivity reaction with a marked transaminasemia in which discontinuance of the dapsone regimen and early institution of prednisone ther¬ apy were accompanied by rapid improvement. This report focuses on the hepatic involvement in the sulfone syndrome, about which little is known.…”

mentioning

confidence: 97%

Liver Involvement in the Sulfone Syndrome

Johnson¹,

Cattau²,

Kuritsky³

et al. 1986

Arch Intern Med

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“…The cardinal features are fever, exfoliative dermatitis, lymphadenopathy, lymphocytosis, methemoglobinemia, hemolytic anemia and hepatotoxicity. Dapsone syndrome is a type of drug rash with eosinophilia and systemic symptoms (DRESS) syndrome 4 .…”

Section: Discussionmentioning

confidence: 99%