Dapsone 4,4diaminodiphenylsulphone is used mainly as an antiinflammatory and antibacterial agent for the treatment of skin diseases, bacteria, and fungi. Dapsone hypersensitivity syndrome ronald prussick, md, frcpc, and nell h. Dapsone can cause several adverse effects, the most serious being dapsone hypersensitivity syndrome dhs, which is potentially fatal. Skin biopsy showing perivascular lymphocytic infiltrates with. Leukocytoclastic vasculitis resolution with topical dapsone. Kumar et al, robbins and cotran pathologic basis of disease.
Drug hypersensitivity syndrome dhs, recently being also referred to as dress drug reaction with eosinophilia and systemic symptoms or didmohs druginduced delayed multiorgan hypersensitivity syndrome, is increasingly being recognized as a distinct type of adverse drug reaction. Hypersensitivity reactions to dapsone are potentially fatal adverse drug reactions with unknown prevalence and risk factors. Dapsone hypersensitivity syndrome dhs is a rare potentially fatal systemic idiosyncratic adverse reaction, with multiorgan involvement also known as sulphone syndrome which is particularly seen in leprosy patients who are on world health organization recommended multidrug therapy whomdt regimen. Dapsone hypersensitivity syndrome dhs is one of the most serious adverse reaction of dapsone. This user guide provides guidance on accessing portable document format pdf documents for blind and visually impaired users of screen reading technology. Dapsone is still widely used for a range of infectious and inflammatory diseases. Chronic cough hypersensitivity syndrome cough full text. Leprosy is a stigmatizing, chronic infection which degenerates the nervous system and often leads to incapacitation. Dapsone is used when a person has experienced adverse effects or toxicity to the drug of choice for pcp, trimethoprimsulfamethoxazole tmpsmx, bactrim, septra and others. The most frequent associated side effects are doserelated hemolytic anemia and methaemoglobinemia 2.
Dapsone hypersensitivity syndrome dhs is a rare yet potentially fatal adverse drug reaction caused by dapsone 4,4 0 diaminodiphenylsulfone dds, a widely used medication in the treatment of. The reaction included fever, malaise, dermatitis, jaundice with hepatic dysfunction, lymphadenopathy, and hemolytic anemia. Drug hypersensitivity syndrome kumari r, timshina dk. Dapsone hypersensitivity syndrome dhs is a rare potentially fatal systemic idiosyncratic adverse reaction, with multiorgan involvement also known as sulphone syndrome which is particularly seen in leprosy patients who are on world health organization. There is more to an accessible pdf file than tags, but an untagged pdf would not be considered accessible. Dapsone induced cholangitis as a part of dapsone syndrome. A case of dapsone hypersensitivity syndrome dhs in an aids patient receiving dapsone for pneumocystis pneumonia pcp prophylaxis is discussed. Piperacillintazobactaminduced drug hypersensitivity. Urticarial vasculitis uv is considered a clinicopathologic entity consisting of two elements. 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. There are several advantages to viewing cough hypersensitivity.
Dapsone hypersensitivity syndrome dhs is characterized by fever, hepatitis, generalized exfoliative dermatitis and lymphadenopathy. Dapsone is used in the treatment of infections and inflammatory diseases. Pdf accessibility defining pdf accessibility webaim. Serum sickness from large amounts of antigen such as injection. A 50yearold caucasian male with a history of aids was admitted with suspicion of pneumonia. More rarely, dapsone can cause severe adverse effects, such as dapsone hypersensitivity syndrome. Complete atrioventricular block associated with dapsone. They can be signed electronically, and you can easily view pdf files.
Pdf dapsoneinduced hypersensitivity syndrome, hemolytic. It involves primarily a widespread skin rash, fever, swollen lymph nodes, and characteristic blood abnormalities such as an abnormally high level of eosinophils, low number of platelets, and increased number of atypical white. Journal of the association of physicians of india vol 62 published on 1st of every month 1st august, 2014 dapsone hypersensitivity syndrome with myocarditis carmen m pereira, marina vaz, sindhoora kotha, nh santosh abstract drug hypersensitivity with myocarditis is known to occur with many drugs especially with antiepileptics. Set the language dropdown under file properties advanced tab to the. Given this drugs favorable sideeffect profile compared to the currently available alternatives, we believe it is a reasonable option in selected patients. The clinical presentation consisted of shortness of breath, occasional hemoptysis, odynophagia, skin rash, transaminitis, anemia. Dapsone hypersensitivity syndrome overlaps reversal. Dapsone hypersensitivity syndrome in a leprosy patient.
Case report severe dapsone hypersensitivity syndrome. A 47yearold female complained of a spreading red patches on the skin of her trunk and. The dapsone hypersensitivity syndrome, which is associated with a reported mortality of 9. To the editor we congratulate liu et al1 for their work involving proactive hla screening to prevent dapsone hypersensitivity syndrome dhs in patients with leprosy. The need for a more reliable route of administration led to investigation the possibility of an i. Here we report a case of severe, life threatening dapsone systemic hypersensitivity syndrome in a 17yearold male who presented with high grade fever, eosinophilia, lymphadenopathy, skin rash, hepatitis and encephalopathy, which was managed successfully with. Dapsone hypersensitivity syndrome in a patient with.
Dapsone hypersensitivity syndrome dhs is a rare yet potentially fatal adverse drug reaction caused by dapsone 4,4. Dapsone induced hypersensitivity syndrome, hemolytic anemia, and severe agranulocytosis article pdf available june 2015 with 96 reads how we measure reads. Dapsone hemolysis, hepatitis, photosensitive dermatitis, pruritus, dapsone hypersensitivity syndrome, methaemoglobinaemia clofazimine darkening of skin, gi complaints, dryness of the skin and eyes, pruritus rifampicin reddish discoloration of urine, urticaria, gi complaints, leucopenia, eosinophilia, thrombocytopenia, liver. Beacons chemicals pte ltd, singapore is routinely prescribed for antimalarial chemoprophylaxis in military servicemen in singapore who are not glucose6phosphate dehydrogenasedeficient.
Case report dapsone hypersensitivity syndrome not related. Case report severe dapsone hypersensitivity syndrome o sener,1 l doganci,2 m safali,3 b besirbellioglu,4 f bulucu,5 a pahsa 4 1 division of allergy, 2 department of microbiology and clinical microbiology, 3 department of pathology, 4 department of infectious diseases, and 5 department of internal medicine gulhane military medical academy. A hypersensitivity reaction to lowdose 50mg, shortterm daspone administration developed in a 16yearold girl. I wish to import a pdf file to accompany my post in facebook. Pdf documents can contain links and buttons, form fields, audio, video, and business logic. Pdf hypersensitivity syndrome associated with dapsone. Dapsone dds is an antibiotic associated with hypersensitivity reactions in 0. Drug reaction with eosinophilia and systemic symptoms.
A different paradigm has evolved in which cough is viewed as the primary condition characterised by afferent neuronal hypersensitivity and different aspects of this syndrome are manifest in the different phenotypes of cough. Moreover, dapsone is the drug of choice for the management of erythema elevatum diutinum eed 2. Dhs is characterized by a hypersensitivity response to the drug, dapsone which is a sulfone. Drug reaction with eosinophilia and systemic symptoms dress, also termed druginduced hypersensitivity syndrome dihs, is a rare reaction to certain medications. Dapsone hypersensitivity syndrome dhs is an adverse effect from dapsone therapy that may occur in 56 weeks to 6 months after initial treatment. Dapsone can rarely cause a hypersensitivity reaction called dapsone syndrome, consisting of fever, hepatitis, exfoliative dermatitis, lymphadenopathy and hemolytic anemia. Dapsone avlosulfon aids information, education, action. Amino acid variants of hladrb1 confer susceptibility to dapsone hypersensitivity syndrome in addition to hlab. Notify physician immediately because these signs may indicate serious hypersensitivity reactions. For a replication analysis, we genotyped 24 snps in an additional 31 participants with the dapsone hypersensitivity syndrome and 1089 controls and performed nextgeneration sequenc. Furthermore, there had been reports of dapsone hypersensitivity syndrome dhs which also challenges. Dapsone is indicated for the treatment of leprosy, but it is also used for various skin diseases 1. Currently, no tests are available to predict the risk of the dapsone hypersensitivity syndrome. To achieve effective blood levels for 34 weeks, suspensions of large dapsone particles in an aqueous vehicle were made.
Presumed dapsoneinduced drug hypersensitivity syndrome. Topical dapsone may provide similar efficacy with far fewer adverse effects. However, the use of dapsone may be associated with a plethora of adverse effects, some of which may involve. Adverse reactions to dapsone, a potent antiinflammatory, antiparasitic compound, first line drug for leprosy include dramatic, generalized hypersensitivity syndrome termed as dapsone syndrome which has a frequency of 0. Monitor signs of hypersensitivity reactions, including skin reactions rash, hives, itching and stevensjohnson syndrome severe dermatitis and exfoliation. Dhs is characterized by exfoliative dermatitis, fever, internal organ involvement lungs, liver, spleen, and kidney. Herein, we describe the practical difficulties in translating this screening into clinical practice in india.
Pdf format is a file format developed by adobe in the 1990s to present documents, including text formatting. Shear, md, frcpc toronto, ontario, canada we describe a 22yearold woman with cutaneous polyarteritis nodosa in whom dapsone hy persensitivity syndrome dhs developed 5 weeks after initiation of dapsone therapy. Dapsone hypersensitivity syndrome that occurred during. Studies in the rat revealed that dapsone dependent methaemoglobinaemia could be greatly diminished. Facebook allows its members to attach and upload pdf files. Drug hypersensitivity syndrome dhs is characterized by a triad of fever, skin eruption, and internal organ involvement. Hla screening for dapsone hypersensitivity in indiaa long.
Chronic cough has been suggested to be due to three conditions, asthma, post nasal drip, and reflux disease. Accessing pdf documents with assistive technology a. Although clinical diagnosis is indicative of a drug hypersensitivity reaction, studies have not been performed to define whether dapsone or a metabolite activates specific tcells. Dapsone hypersensitivity syndrome dhs can be considered a manifestation of dress drug rash with eosinophilia and systemic symptoms syndrome and is an idiosyncratic multiorgan disease. Pdf is untagged, the pdf contains no tags documents without tags do not. Thus, the aims of this study were to i explore the immunogenicity dds and nitroso dds ddsno using pbmc from.
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