Dapsone‐induced methemoglobinemia in renal transplant recipients: more prevalent than previously thought

Mitsides, Nicos; D, Green; Middleton, Rachel; New, David; Lamerton, Elizabeth; Allen, Judith E.; Redshaw, J; Chadwick, Paul; Subudhi, Chinari; Wood, Grahame

doi:10.1111/tid.12161

Cited by 19 publications

(22 citation statements)

References 21 publications

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“…Furthermore, when the MetHb concentration is elevated in red blood cells, it leads to tissue hypoxia (Skold et al 2011 ; Cortazzo and Lichtman 2014 ). Patients are particularly susceptible to worsening methaemoglobinaemia in the presence of oxidizing agents (Mitsides et al 2014 ; Sohn et al 2014 ; Wieringa et al 2014 ). Medications or agents such as anaesthetics (e.g.…”

Section: Introductionmentioning

confidence: 99%

Global methaemoglobinaemia research output (1940–2013): a bibliometric analysis

et al. 2015

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Bibliometric studies, which involve the use of statistical methods, are increasingly being used for research assessment. A bibliometric analysis was conducted to evaluate the publication pattern of methaemoglobinaemia research output at the global level based on the Scopus database. We analysed selected documents with “methemoglobinemia”, or “methaemoglobinaemia” as a part of the title and reported the following parameters: trends of publication output, country of publication, journal pattern, collaborative measures, citations pattern, and institute productivity. A total of 1770 articles were published worldwide. The time trend for the number of articles showed an increase after 2000. The highest number of articles related to methaemoglobinaemia was from the USA (24.8 %), followed distantly by the UK (4.5 %), India (3.7 %), and France (3.7 %). No data related to methaemoglobinaemia were published from 152 countries. The total number of citations at the date of data collection was 10,080, with an average of 5.7 citations per document. The USA and UK had the highest h-index of 31 and 14, respectively, and six countries had an h-index of 9–14. It is notable that Canada was ranked eighth in the number of publications but fourth in h-index and India was ranked third in the number of publications but eighth in h-index. Furthermore, Canada produced the most internationally collaborated papers out of the total number of publications for each country (16.1 %), followed by the UK (13.9 %). This bibliometric analysis provides data contributing to a better understanding of the methaemoglobinaemia research field. The number of publications on methaemoglobinaemia increased significantly after 2000. The USA was the most productive country as measured by total publications. The USA and UK achieved the highest h-index in the field of methaemoglobinaemia research, signifying a higher quality of research than other countries.

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Section: Introductionmentioning

confidence: 99%

Global methaemoglobinaemia research output (1940–2013): a bibliometric analysis

et al. 2015

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“…We observed a small but significant number of patients with dapsone‐related oxidative hemolysis within the first 1‐2 months, leading to the risk and expense of potentially avoidable blood transfusions. A higher reported incidence in other transplant cohorts, too, has resulted in greater hospitalization and transfusion requirements …”

Section: Discussionmentioning

confidence: 99%

Dapsone safety in hematology patients: Pathways to optimizing Pneumocystis jirovecii pneumonia prophylaxis in hematology malignancy and transplant recipients

Urbancic

Pisasale

Wight

et al. 2018

Transplant Infectious Dis

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Dapsone may be used for Pneumocystis jirovecii pneumonia (PJP) prophylaxis in hematology patients receiving immunosuppressive therapy or after hematopoietic stem cell transplant (HSCT) in the setting of trimethoprim-sulfamethoxazole (TMP-SMX) adverse drug reaction (ADR) history. Dapsone-induced hematological toxicities such as oxidative hemolysis may limit use in these patients and modern assessments of dapsone allergy cross-reactivity in non-HIV patients with a sulfonamide allergy are largely absent. The aim of this single-centre, retrospective study was to describe dapsone usage in hematology patients requiring PJP prophylaxis, including HSCT recipients, over a 12-month period in terms of indications, incidence of dapsone-attributed oxidative hemolysis, and immune cross-reactivity in those previously labeled with a sulfonamide allergy, as well as describing potential opportunities for first-line TMP-SMX PJP prophylaxis reintroduction. Of 24 patients meeting the study inclusion criteria, 12 (50%) were receiving dapsone PJP prophylaxis post-HSCT. No cases of breakthrough PJP infection were noted. Sixteen patients (67%) were initiated on dapsone to avoid the perceived risk of further myelosuppression with TMP-SMX and five patients (21%) because of prior delayed immune-mediated allergy to TMP-SMX. None experienced rash with dapsone therapy. Six patients (25%) were successfully rechallenged on TMP-SMX, including one patient with prior TMP-SMX-associated rash. Four (17%) patients had confirmed oxidative hemolysis, all resulting in dapsone cessation. Dapsone PJP prophylaxis in hematology patients was effective and safe, with nonlife threatening dapsone-related hemolysis noted in a small number. An absence of sulfonamide allergy cross-reactivity was noted, suggesting greater TMP-SMX rechallenges or desensitization could be considered in those receiving dapsone.

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“…However, it should be noted the use of these agents as opposed to TMP‐SMX, leads to higher PCP breakthrough rates . Furthermore, like TMP‐SMX, the use of these alternative agents is sometimes contraindicated or is associated with severe side effects …”

Section: Who Should Be Protected?mentioning

confidence: 99%

“…32 Furthermore, like TMP-SMX, the use of these alternative agents is sometimes contraindicated or is associated with severe side effects. 44,45 By the above factors, it can be explained that the diagnosis of PCP is still encountered with some regularity in any clinical practice that is responsible for the care of immune-compromised patients.…”

Section: Who S Hould B E Protec Ted?mentioning

confidence: 99%

Healthcare related transmission of Pneumocystis pneumonia: From key insights toward comprehensive prevention

Boer

Walzer

Mori³

2018

Transplant Infectious Dis

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In at risk populations, Pneumocystis pneumonia (PCP) may occur as a solitary event as well as in a cluster- or outbreak setting due to interpatient transmission of Pneumocystis jirovecii. Despite the data and insights obtained from studies of outbreaks of PCP, the development and implementation of comprehensive recommendations for the prevention of healthcare related transmission of P. jirovecii have been delayed. Both optimization of chemoprophylaxis strategies as well as combination with prudent use of isolation precautions are warranted to achieve this goal. The rationale of the available measures for the prevention of PCP should be viewed in the context of what is currently known about the complex biology and epidemiology of P. jirovecii. From there, phased but practical prevention strategies can be deducted to balance the efforts, costs and negative consequences of chemoprophylaxis and isolation precautions with the beneficial effect of preventing healthcare related transmission of P. jirovecii and development of PCP.

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Dapsone‐induced methemoglobinemia in renal transplant recipients: more prevalent than previously thought

Abstract: This is the highest reported prevalence of MHb, to our knowledge, in patients receiving dapsone, and its use led to significant hospitalization in this population. This study raises concerns about the use of dapsone as chemoprophylaxis in renal transplant recipients.

Cited by 19 publications

References 21 publications

Global methaemoglobinaemia research output (1940–2013): a bibliometric analysis

Global methaemoglobinaemia research output (1940–2013): a bibliometric analysis

Dapsone safety in hematology patients: Pathways to optimizing Pneumocystis jirovecii pneumonia prophylaxis in hematology malignancy and transplant recipients

Healthcare related transmission of Pneumocystis pneumonia: From key insights toward comprehensive prevention

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