The dapsone syndrome

Kromann, N. P.

doi:10.1001/archderm.118.7.531

Cited by 7 publications

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“…Hepatocellular injury is more severe, characterized by elevated transaminases with liver biopsy showing predominantly eosinophilic lobular and portal infiltration whereas, cholestatic injury is less severe with high alkaline phosphatase level, modest rise in transaminases level, and may have granuloma on biopsy. The mechanism of injury, including hepatotoxicity in dapsone syndrome, seems to be a hypersensitivity reaction [9]. The incidence of DHS was found 1.4% with an overall case-fatality of 9.9% in a review [6].…”

Section: Discussionmentioning

confidence: 99%

Dapsone Hypersensitivity Syndrome With Leukemoid Reaction and Severe Thrombocytosis

Pahadiya¹,

Lakhotia²

2021

Cureus

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Hypersensitivity reactions to dapsone are common and potentially fatal adverse drug reactions. Herein, we report a case of a 45-year-old female who presented with fever, generalized desquamating rashes, and icterus three weeks after initiation of dapsone therapy for leprosy neuritis. She was diagnosed to have dapsone hypersensitivity syndrome (DHS) with leukemoid reaction and thrombocytosis. Dapsone was immediately discontinued, and she has treated with prednisolone 50 mg daily for a month and tapered over the next month. She has improved completely. DHS, leukemoid reaction, and severe thrombocytosis, or these adverse drug reactions to dapsone have rarely been reported.

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Section: Discussionmentioning

confidence: 99%

Dapsone Hypersensitivity Syndrome With Leukemoid Reaction and Severe Thrombocytosis

Pahadiya¹,

Lakhotia²

2021

Cureus

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“…Eosinophilia generally occurs, supporting the reaction to most likely be hypersensitivity rather than a toxic reaction. 1,2,5,6 Liver biopsy usually shows hepatitis with parenchymal epithelioid cell granulomas and eosinophilia. 2,6 Johnson et al 3 described liver involvement in patients with sulfone syndrome to be both cholestatic and hepatocellular injuries.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,5,6 Liver biopsy usually shows hepatitis with parenchymal epithelioid cell granulomas and eosinophilia. 2,6 Johnson et al 3 described liver involvement in patients with sulfone syndrome to be both cholestatic and hepatocellular injuries. When hepatic injury occurs, the cholestatic pattern has a less severe course than the hepatocellular type once the drug has been discontinued.…”

Section: Discussionmentioning

confidence: 99%

“…This is explained by prolonged retention of dapsone, which is facilitated by hepatic storage and the enterohepatic circulation of the drug. 3,5,6 A review of the literature found 21 cases of sulfone syndrome. 2 Common features were usual dapsone dose 50–300 mg/d, all cases occurred within 2 months of starting dapsone therapy, all patients had fever, and all but 3 of the patients had rash and evidence of hepatic injury.…”

Section: Discussionmentioning

confidence: 99%

“…Rationale for prednisone use is the prolonged retention of dapsone even after drug discontinuation as described previously. Patient symptoms have been said to resolve with 1,3 and without 5,6 prednisone therapy; fatal reactions have occurred even with steroid use. 11 Prednisone regimens have been 60 mg/d for 5 days, then gradually tapered over a 1-month period 1 or 60 mg/d for 5 days, 40 mg/d, then tapered over 1 month to 5 mg/d, then gradually tapered over the next 6 months.…”

Section: Discussionmentioning

confidence: 99%

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Dapsone-Induced Sulfone Syndrome

Lee

Nashed

2003

Ann Pharmacother

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Extreme lymphoplasmacytosis and hepatic failure associated with sulfasalazine hypersensitivity reaction and a concurrent EBV infection—case report and review of the literature

et al. 2003

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We present an unusual case of a patient with extreme lymphoplasmacytosis and hepatic failure in association with a reaction to sulfasalazine and a concurrent Epstein-Barr virus (EBV) infection. Sulfa drugs can cause a wide range of allergic and hypersensitivity reactions and occasionally can lead to a fulminant illness. In the case under discussion the patient had hepatotoxicity, skin rash, fever, and peripheral blood atypical lymphocytosis. Initial impressions suggested the possibility of a malignant lymphoproliferative disorder. Flow cytometry of peripheral blood and a bone marrow biopsy provided clear evidence for a reactive, polyclonal process as opposed to a malignant disorder. Cessation of the offending drug and administration of steroids led to dramatic improvement. This case illustrates that drug hypersensitivity reactions can be manifested by an extreme lymphocytoid leukemoid reaction.

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The dapsone syndrome

Cited by 7 publications

References 0 publications

Dapsone Hypersensitivity Syndrome With Leukemoid Reaction and Severe Thrombocytosis

Dapsone Hypersensitivity Syndrome With Leukemoid Reaction and Severe Thrombocytosis

Dapsone-Induced Sulfone Syndrome

Extreme lymphoplasmacytosis and hepatic failure associated with sulfasalazine hypersensitivity reaction and a concurrent EBV infection—case report and review of the literature

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