RESUMO
BACKGROUND: Dapsone hypersensitivity syndrome (DHS) is a potentially life-threatening adverse drug reaction consisting of fever, hepatitis, exfoliative dermatitis, lymphadenopathy and hemolytic anemia. The incidence of DHS is estimated to be 2% in leprosy patients. Because the incidence of this drug eruption may be different in different ethnicities and diseases, we thought to investigate the incidence of DHS in non-leprosy patients. METHODS: This is a retrospective study to examine the incidence, clinical manifestations and prognosis of DHS in non-leprosy patients who were given dapsone at the National Taiwan University Hospital between June 2001 and December 2005. RESULTS: The incidence of DHS among non-leprosy patients was 1.66%. These patients ran a relatively benign course as compared with leprosy patients. CONCLUSION: The incidence of DHS among non-leprosy patients was compatible to that observed among leprosy patients. DHS in non-leprosy patients runs a favorable course with low morbidity in our study.
Assuntos
Dapsona/efeitos adversos , Hipersensibilidade a Drogas/etiologia , Hospitais de Ensino , Hansenostáticos/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia Hemolítica/induzido quimicamente , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Criança , Pré-Escolar , Dapsona/administração & dosagem , Dermatite Esfoliativa/induzido quimicamente , Hipersensibilidade a Drogas/complicações , Hipersensibilidade a Drogas/tratamento farmacológico , Hipersensibilidade a Drogas/epidemiologia , Feminino , Febre/induzido quimicamente , Humanos , Incidência , Pacientes Internados/estatística & dados numéricos , Hansenostáticos/administração & dosagem , Doenças Linfáticas/induzido quimicamente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Dermatopatias/tratamento farmacológico , Síndrome , Taiwan/epidemiologiaAssuntos
Dapsona/efeitos adversos , Hansenostáticos/efeitos adversos , Hanseníase Dimorfa/fisiopatologia , Rifampina/efeitos adversos , Adulto , Antígenos de Bactérias/imunologia , Dapsona/uso terapêutico , Dermatoses Faciais/induzido quimicamente , Dermatoses Faciais/tratamento farmacológico , Febre/induzido quimicamente , Humanos , Hansenostáticos/uso terapêutico , Hanseníase Dimorfa/tratamento farmacológico , Masculino , Mycobacterium leprae/imunologia , Doenças do Sistema Nervoso Periférico/etiologia , Filipinas/etnologia , Prednisona/uso terapêutico , Rifampina/uso terapêutico , Uveíte/induzido quimicamente , Uveíte/imunologiaRESUMO
BACKGROUND: Dapsone can rarely cause a hypersensitivity reaction called dapsone syndrome, consisting of fever, hepatitis, exfoliative dermatitis, lymphadenopathy and hemolytic anemia. Dapsone syndrome is a manifestation of the DRESS (drug rash with eosinophilia and systemic symptoms) syndrome which is a serious condition that has been reported in association with various drugs. Cholangitis in dapsone syndrome has not been reported so far in the world literature. CASE PRESENTATION: We report a patient who presented with fever, exfoliative dermatitis, jaundice and anemia within three weeks of starting of dapsone therapy. These features are typical of dapsone syndrome, which is due to dapsone hypersensitivity and is potentially fatal. Unlike previous reports of hepatitic or cholestatic injury in dapsone syndrome we report here a case that had cholangitic liver injury. It responded to corticosteroids. CONCLUSION: We conclude that cholangitis, though unusual, can also form a part of dapsone syndrome. Physicians should be aware of this unusual picture of potentially fatal dapsone syndrome.
Assuntos
Colangite/induzido quimicamente , Dapsona/efeitos adversos , Hipersensibilidade a Drogas/etiologia , Febre/induzido quimicamente , Hansenostáticos/efeitos adversos , Adulto , Toxidermias/etiologia , Humanos , Hiperbilirrubinemia/induzido quimicamente , Masculino , SíndromeAssuntos
Hipersensibilidade a Drogas/etiologia , Rifampina/efeitos adversos , Adulto , Complexo Antígeno-Anticorpo/imunologia , Hipersensibilidade a Drogas/imunologia , Feminino , Febre/induzido quimicamente , Cefaleia/induzido quimicamente , Humanos , Hanseníase/tratamento farmacológico , Masculino , Náusea/induzido quimicamente , Síndrome , Vômito/induzido quimicamenteRESUMO
Two cases of 'flu' syndrome on once monthly rifampicin are reported. The symptoms were reproduced in one patient with the next supervised dose. In the second patient they did not recur probably because she was receiving systemic steroids for left ulnar neuritis.