Dapsone
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Agranulocytosis: 2 case reports Two women developed agranulocytosis during dapsone therapy for tuberculoid leprosy; one woman subsequently died. A 35-year-old woman started receiving a 6-month course of dapsone 100 mg/day and rifampicin, and presented with a 1-week history of an acute febrile illness 2 months after treatment initiation. Laboratory investigations showed a WBC count of 500/mm3 , 0% of neutrophils, and signs of haemolysis; a bone marrow analysis revealed fungi-like hyphae and hypocellular marrow. She received broadspectrum antibiotics, antifungals and granulocyte colony stimulating factor (GCSF), and made a complete recovery. A 28-year-old woman, who had started receiving a 6-month course of dapsone 100 mg/day and rifampicin 2 months earlier, presented with a 3-day history of a febrile illness and otitis media. Laboratory investigations showed a WBC count of 500/mm3, 0% of neutrophils, and evidence of haemolysis. Treatment with broad-spectrum antibiotics, antifungals and GCSF was initiated, but she died within 72 hours of admission. Postmortem analysis showed filamentous organisms in her lungs. Satarasinghe RL, et al. Total agranulocytosis caused by dapsone therapy for tuberculoid leprosy - An unappreciated serious side effect of anti-leprosy treatment with clinical implications. Drug Metabolism and Drug Interactions 24: 325-329, 803023641 No. 2-4, 2009 - Sri Lanka
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Reactions 3 Jul 2010 No. 1308
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