Dapsone
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Acute haemolytic anaemia: case report A 45-year-old woman with acute lymphoblastic leukaemia (ALL) developed acute haemolytic anaemia while receiving dapsone for Pneumocystis carinii pneumonia prophylaxis. The woman had previously received chemotherapy for ALL and started dapsone [route and dosage not stated] before discharge. She was scheduled for a bone marrow evaluation 4 weeks after chemotherapy. Several days prior to this scheduled visit, she developed light-headedness, fatigue and exertional dyspnoea [time to reaction onset not clearly stated]. Significant laboratory findings include reduced haematocrit, RBC count, and haemoglobin and haptoglobin levels. She had elevated AST, ALT, ALP, LDH and total bilirubin levels. A peripheral blood smear revealed marked anisopoikilocytosis and significant RBC changes, such as course basophilic stippling, Howell-Jelly bodies, Pappenheimer bodies, and schistocytes/red cell fragments. These findings led to a diagnosis of acute haemolytic anaemia, due to extrinsic causes, as a bone marrow biopsy showed trilineage haematopoiesis and an absence of overt ALL. The woman received a transfusion of two units of compatible RBCs. She discontinued dapsone, and her peripheral blood findings progressively resolved. She received standard consolidation therapy for her ALL. Her erythroid population had normalised on follow-up bone marrow evaluation, with no evidence of acute leukaemia. Author comment: "Most likely diagnosis: Dapsoneinduced non-autoimmune hemolytic anemia." Pendse A, et al. Unexpected cause of anemia in a 45-year-old patient with acute lymphoblastic leukemia. Laboratory Medicine 41: 645-648, No. 11, Nov 2010. Available from: URL: http://dx.doi.org/10.1309/lmk7oa1gyp3srdbd 803046673 USA
0114-9954/10/1333-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 8 Jan 2011 No. 1333
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