Dapsone-Induced Sulfone Syndrome

Abstract

Although sulfone syndrome appears to be relatively uncommon, healthcare practitioners must be aware of the potentially fatal syndrome associated with dapsone use.

Dapsone as a Glucocorticoid-Sparing Agent in Maintenance-Phase Pemphigus Vulgaris

“…Other, rare, adverse effects include blood dyscrasias, exfoliative dermatitis, hepatic damage (which may be dose dependent), 16 mood or other mental changes, peripheral neuritis, and "sulfone syndrome," which has been reported to occur in less than 0.5% to 2% of cases. 17 None of the patients in the present series had to discontinue dapsone therapy owing to an adverse reaction. While we monitored methemoglobinemia clinically, we performed liver function tests and measured levels of hemoglobin regularly and evaluated glucose-6-phosphate dehydrogenase prior to initiation of therapy.…”

Rare case of aplastic anemia precipitated by dapsone: A Case report

“…Infections, drugs, solvents and other chemical agents have been associated with aplastic anemia, but it is difficult to prove whether there is a causal relationship, given the absence of confirmatory cases. [3] Dapsone is a drug that is known to be associated with serious hematological ADR, including agranulocytosis, [4] hemolytic anemia and, [6,7] more rarely, aplastic anemia. [8,9] Aplastic anemia seen with dapsone may be either of two types; early or late.…”

Dapsone Hypersensitivity Syndrome in a Patient With Acquired Immunodeficiency Syndrome

“…23 There is currently very limited literature that describes DHS in HIV/AIDs patients, so practitioners may be unaware of how the syndrome may present differently in this patient population. [5][6][7][8][9] There were 2 case reports published that describe DHS in patients receiving dapsone for PCP prophylaxis in which neither patient presented with the classic lymphadenopathy although both patients presented with fever. 6,8 The other case reports discuss patients with higher CD4+ counts ranging from 26 to 237 cells/mm 3 , which could explain why those patients were able to mount a fever unlike this patient.…”

“…Other severe internal organ impairment has been observed, such as carditis, pneumonitis, and colitis, all of which can lead to increased mortality. [4][5][6][7][8][9][10][11][12][13][14][15] Overall, the incidence of DHS has been reported to range from 0.5% to 3%; however, the incidence for patients receiving dapsone for Pneumocystis pneumonia (PCP) prophylaxis is not well established. [11][12][13][14]16 Current guidelines recommend dapsone as monotherapy or in combination with pyrimethamine plus leucovorin as an alternative treatment for primary prophylaxis of PCP and Toxoplasma gondii in HIV-infected patients who cannot tolerate first-line treatment with trimethoprim-sulfamethoxazole (TMP-SMX).…”

“…This search yielded only 5 case reports specifically discussing DHS in patients infected with HIV/AIDs. [5][6][7][8][9] Results from a review article showed that certain risk factors such as mucosal involvement, hepatitis, higher age, and disease occurrence in nonaffluent countries were associated with higher risk of mortality. 10 A genetic defect known as glucose-6-phosphate dehydrogenase (G6PD) deficiency is also associated with an increased risk of hemolytic anemia when given with oxidative drugs such as dapsone.…”