Artifactually Low Hemoglobin ALC Caused by use of Dapsone

Albright, Eric S.; Ovalle, Fernando; Bell, David S.H.

doi:10.4158/ep.8.5.370

Cited by 34 publications

(31 citation statements)

References 13 publications

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“…Second, dapsone promotes the oxidation of hemoglobin to methemoglobin, which interferes with the high-performance liquid chromatography assay used to measure HbA 1c , since it will not spike in the correct HbA 1c location and hence, will give a falsely low value (4,8,12–14,16). In addition, diminished activity of nicotinamide adenine dinucleotide-methemoglobin reductase leads to decreased breakdown of methemoglobin and further affects the HbA 1c measurement (13). Finally, dapsone is thought to reduce erythrocyte survival independent of its hemolytic effect (4,13).…”

Section: Discussionmentioning

confidence: 99%

Falsely Decreased Hba1c in A Type 2 Diabetic Patient Treated with Dapsone

2014

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Objective To discuss a case of a falsely low hemogloin A1c (HbA1c) in a transplant patient treated with dapsone and its implications. HbA1c is widely used as a measure of glycemic control in diabetic patients. With the increasing transplant population, it is important to be mindful of medications used in this population that can affect HbA1c and to use other measures of glycemic control to guide treatment decisions. Methods We present details of the case and review the relevant literature. Results A 61-year-old patient received a liver transplant in 2012 and subsequently was noted to have a falling HbA1c despite evidence of hyperglycemia based on finger-stick glucose and fructosamine measurements. Review of the medical records revealed that the discordance between HbA1c and fingerstick glucose levels developed after initiation of dapsone therapy. Dapsone may lead to a falsely low HbA1c via several mechanisms. Upon cessation of dapsone therapy, the patient’s HbA1c returned to pre-dapsone levels. Conclusion It is important to be aware of medications commonly used in transplant patients that may lead to a falsely low HbA1c level so that incorrect treatment decisions are not made. Fructosamine correlates with HbA1c and can be used as a measure of glycemic control in transplant patients when HbA1c cannot be used.

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Section: Discussionmentioning

confidence: 99%

Falsely Decreased Hba1c in A Type 2 Diabetic Patient Treated with Dapsone

2014

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“…20 In addition to erythropoietin, medications that affect RBC mass, such as dapsone, 21 will affect A1C results.…”

Section: Rbc Lifespanmentioning

confidence: 99%

The Challenge of the Use of Glycemic Biomarkers in Diabetes: Reflecting on Hemoglobin A1C, 1,5-Anhydroglucitol, and the Glycated Proteins Fructosamine and Glycated Albumin

Wright¹,

Hirsch²

2012

Diabetes Spectrum

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F r o m r e s e a r c h t o P r a c t i c e / G ly c e m i c m a r k e r s : a r e v i e w o F t h e t o o l s w e a l l l o v e , P e r h a P s t o o D e a r ly ? In BriefThis article reviews the advantages and limitations of the current glycemic biomarkers, including A1C, 1,5-anhydroglucitol, and the glycated proteins fructosamine and glycated albumin. It provides patient encounter case studies and related discussion to guide health care professionals on the appropriate use of the various glycemic biomarkers in clinical practice.

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“…), alcoholism, and chronic renal disease may affect HbA1c levels via decreasing erythrocyte survival (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Extraordinarily Low Level of HbA1c due to Hemolytic Anemia

Civelek

Kılıç

Sümer

et al. 2016

GMJ

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HbA1c measurement gives us information about glycemic levels in patients with diabetes mellitus for the last 3 months. Some factors such as drugs, anemia (hemolytic anemia, hemoglobinopathies etc.), alcoholism, renal failure may affect HbA1c levels via decreasing erythrocyte survival. Herein, we report a very rare clinical presentation of a case of geriatric male patient with an extraordinarily low level of HbA1c (2.7%) which was caused by immune hemolytic anemia associated with chronic lymphocytic leukemia.

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Artifactually Low Hemoglobin ALC Caused by use of Dapsone

Cited by 34 publications

References 13 publications

Falsely Decreased Hba1c in A Type 2 Diabetic Patient Treated with Dapsone

Falsely Decreased Hba1c in A Type 2 Diabetic Patient Treated with Dapsone

The Challenge of the Use of Glycemic Biomarkers in Diabetes: Reflecting on Hemoglobin A1C, 1,5-Anhydroglucitol, and the Glycated Proteins Fructosamine and Glycated Albumin

Extraordinarily Low Level of HbA1c due to Hemolytic Anemia

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