Dapsone Therapy Causing Sulfone Syndrome and Lethal Hepatic Failure in an HIV-Infected Patient

Chalasani, Prasad; Baffoe-Bonnie, Henry; Jurado, Rafael

doi:10.1097/00007611-199411000-00018

Cited by 29 publications

(20 citation statements)

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“…Hemolytic anemia, atypical lymphocytosis, and hepatitis are other accompanying findings 6,12. DHS can cause irreversible organ damage or even death if it is not recognized early and managed properly 9,13…”

Section: Introductionmentioning

confidence: 99%

A Review on Dapsone Hypersensitivity Syndrome Among Chinese Patients with an Emphasis on Preventing Adverse Drug Reactions with Genetic Testing

Wang

Parimi

Liu

et al. 2017

The American Society of Tropical Medicine and Hygiene

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Dapsone is a bactericidal and bacteriostatic against Mycobacterium leprae, a causative agent of leprosy. Dapsone is also applied in a range of medical fields because of its anti-inflammatory and immunomodulatory effects. Dapsone hypersensitivity syndrome (DHS) is a rare yet serious adverse drug reaction (ADR) caused by dapsone involving multiple organs. We performed a systematic review of published articles describing dapsone-induced hypersensitivity syndrome, including all Chinese articles and the latest literature available in online databases published between October 2009 and October 2015. We determined the prevalence, clinical characteristics, and mortality rate of DHS. Importantly, we also summarized the recent advances in genetic testing allowing prediction of ADRs. In an initial systematic electronic search, we retrieved 191 articles. Subsequently, these articles were further filtered and ultimately 84 articles (60 Chinese case reports, 21 non-Chinese articles, and three epidemiological studies) were selected, which included 877 patients. The prevalence of DHS among Chinese patients was 1.5% with a fatality rate of 9.6%. Early withdrawal of dapsone and appropriate treatment reduced the fatality rate. Most importantly, genetic screening for the HLA-B*13:01 allele among high-risk populations showed a significant utility as a useful genetic marker to DHS. In conclusion, this review discusses the epidemiological and clinical characteristics of DHS among Chinese patients, which may help physicians to understand this syndrome.

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Section: Introductionmentioning

confidence: 99%

A Review on Dapsone Hypersensitivity Syndrome Among Chinese Patients with an Emphasis on Preventing Adverse Drug Reactions with Genetic Testing

Wang

Parimi

Liu

et al. 2017

The American Society of Tropical Medicine and Hygiene

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“…Another report described an HIV-infected patient with fulminant hepatitis leading to death after 1 month of treatment with dapsone for PCP prophylaxis. 4 Lowe and Smith 7 first identified sulfone syndrome in 1949 when they noted a 2% incidence of exfoliative dermatitis in patients treated for leprosy. It was reported in 1970 as a non-dose-related sensitivity-type reaction that occurs in <0.5% of patients taking dapsone that begins within 1-4 weeks after administration of the drug and, with toxic hepatitis and intrahepatic cholestasis, is seen after 5-6 weeks.…”

Section: Discussionmentioning

confidence: 99%

Dapsone-Induced Sulfone Syndrome

Lee

Nashed

2003

Ann Pharmacother

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“…Reversible hepatic injury has been reported with dapsone and can be either hepatocellular or cholestatic. 91,92 Dapsone-induced hepatotoxicity usually is considered a hypersensitivity reaction (referred to as sulfone syndrome); symptoms include fever, malaise, jaundice, exfoliative dermatitis, lymphadenopathy, methemoglobinemia, and hemolytic anemia. This syndrome is rare, and hepatic involvement ranges from mild increases in transaminase levels to fatal fulminant hepatitis.…”

Section: Anti-pneumocystis Agentsmentioning

confidence: 99%

“…This syndrome is rare, and hepatic involvement ranges from mild increases in transaminase levels to fatal fulminant hepatitis. 91 Dapsone-induced hepatitis without the classic features of sulfone syndrome also has been described. 92 Trimetrexate, an antimetabolite, is a potent inhibitor of the P. jiroveci dihydrofolate reductase.…”

Section: Anti-pneumocystis Agentsmentioning

confidence: 99%

Looking Beyond Highly Active Antiretroviral Therapy: Drug‐Related Hepatotoxicity in Patients with Human Immunodeficiency Virus Infection

Orenstein

Tsogas

2002

Pharmacotherapy

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Management of human immunodeficiency virus (HIV) has become increasingly complex since the introduction of highly active antiretroviral therapy (HAART). Patients with HIV have become exposed to an increasing array of drugs to treat HIV, prevent opportunistic infections and immune dysfunction, and manage comorbid illnesses and therapeutic complications. Hepatic complications have become common and may lead to discontinuation of treatment and significant morbidity. Up to 90% of patients with acquired immunodeficiency syndrome (AIDS) receive at least one drug that can cause hepatotoxicity. Clinicians treating patients with HIV frequently face difficulty distinguishing abnormal liver transaminase levels and toxicities in patients receiving several drugs. Some potential causes of hepatic dysfunction are viral infections, alcohol and substance abuse, and hepatotoxic drugs such as HAART. Recent reports have focused on the hepatotoxicity of HAART and the role of hepatitis viruses to the exclusion of many other agents prescribed for patients with HIV. Many of the common antibiotics, antifungals, antivirals, and ancillary agents prescribed for patients with HIV are independently associated with hepatotoxicity. Clinicians should be aware of the potential non-antiretroviral hepatotoxic agents that are frequently administered in HIV management.

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Dapsone Therapy Causing Sulfone Syndrome and Lethal Hepatic Failure in an HIV-Infected Patient

Cited by 29 publications

References 0 publications

A Review on Dapsone Hypersensitivity Syndrome Among Chinese Patients with an Emphasis on Preventing Adverse Drug Reactions with Genetic Testing

A Review on Dapsone Hypersensitivity Syndrome Among Chinese Patients with an Emphasis on Preventing Adverse Drug Reactions with Genetic Testing

Dapsone-Induced Sulfone Syndrome

Looking Beyond Highly Active Antiretroviral Therapy: Drug‐Related Hepatotoxicity in Patients with Human Immunodeficiency Virus Infection

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