Dapsone
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Agranulocytosis and haemolytic anaemia: case report A 13-year-old girl developed agranulocytosis and haemolytic anaemia during treatment with dapsone for immune thrombocytopenic purpura (ITP). The girl, who had ITP, started receiving dapsone 100 mg/day [route not stated]. Six weeks after initiation of dapsone therapy, an improvement was noted with increase in platelet count. Other blood counts were not monitored. However, one month later, she presented with cough, high-grade fever, pallor and dyspnoea. She was haemodynamically unstable. Therefore, she was admitted to the paediatric ICU. Laboratory investigations revealed Hb level 6.8 g/dL, absolute neutrophil count 40 /mm3, WBC count 1000 /mm3 and corrected reticulocyte count of 2.6%. Peripheral smear revealed polychromasia. Liver function test demonstrated unconjugated hyperbilirubinemia. Chest radiograph showed left lobe consolidation. Blood culture revealed Klebsiella pneumoniae infection. Bone marrow examination revealed marked suppression of myeloid series and maturation arrest consistent with agranulocytosis. She was diagnosed with agranulocytosis and haemolytic anaemia secondary to dapsone therapy [time to reaction onsets not clearly stated]. The girl was treated with unspecified granulocyte colony stimulating factor and antibiotics. Dapsone therapy was withheld. She also required mechanical ventilation and inotropic support. Ten days later, her clinical condition as well as neutrophil count recovered. Bartakke SP, et al. Dapsone Induced Agranulocytosis and Hemolytic Anemia in Immune Thrombocytopenic Purpura. Indian Journal of Pediatrics 87: 856, 05 Mar 2020. 803504602 Available from: URL: http://doi.org/10.1007/s12098-020-03226-x
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Reactions 3 Oct 2020 No. 1824
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