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At least 397 records · Page 22Linked to original sources
PubMed1993

[Effectiveness of dapsone on refractory immune thrombocytopenia in a patient with systemic lupus erythematosus associated with sarcoidosis].

A 57-year-old man was admitted with massive nasal bleeding and blurred vision in January, 1991. Laboratory examination showed a prominent decrease of platelet number (1,000/microliters) and a marked elevation of PAIgG (4,025 ng/10(7) cells). Serological test revealed positive antinuclear factor, low concentration of C3 and C4, high level of immune complex and polyclonal hypergammaglobulinemia. The patient had uveitis and bilateral hilar lymphadenopathy with a high level of serum lysozyme and negative PPD skin test. The diagnosis of SLE complicated with thrombocytopenia and sarcoidosis was made. In spite of the various trials of treatment, such as oral prednisolone (PSL), methyl-PSL pulse therapy, plasma exchange, high-dose intravenous gammaglobulin, cyclophosphamide, azathioprine, vincristine, colchicine, cyclosporine-A, mizoribine, danazol, ascorbic acid and interferon alpha 2b, the platelet number could not be raised enough to keep more than 10,000/microliters, though the level of PAIgG decreased to 200 ng/10(7) cells. Finally, the administration of 75 mg/day of dapsone brought about a significant rise in platelet number within 2 weeks. The maximum number of 6.2 x 10(4)/microliters was obtained after 2 months. Then the patient stopped himself to take the drug, but the platelet number remained around 4-5 x 10(4)/microliters. Same dose of the drug was again prescribed to confirm the effect of dapsone. The platelet number increased to 7.9 x 10(4)/microliters in 2 weeks, and gradually returned to 5 x 10(4)/microliters after cessation of the drug. Thus being certainly effective against thrombocytopenia, dapsone should be considered as one of the therapeutic choice for refractory autoimmune thrombocytopenia.

Autoimmune Diseases↗
PubMed1996

Dapsone syndrome in cutaneous lupus erythematosus.

Dapsone is increasingly used in the treatment of rheumatic diseases. It is indicated in many inflammatory skin conditions characterized by polymorphonuclear cell infiltration. Minor reactions to the drug are very common, but severe idiosyncratic reactions are rare considering the large number of patients taking this drug worldwide. We describe 2 patients with cutaneous lupus erythematosus who developed severe dapsone reaction after low dose therapy, with a fatal outcome in one. Physicians should be aware of the potentially lethal side effects of dapsone.

Adult↗
PubMedDate not supplied

The contribution of "cure by dapsone monotherapy' to the reduction of prevalence of leprosy in the State of Orissa, India, 1983-1993.

The implementation of multiple drug therapy (MDT) in the State of Orissa, India, started in early 1983 and was extended in a phased manner to nine out of the then total of 13 districts by 1993. As part of a programme to bring the remaining four districts under MDT, an intensive screening of the registers was carried out in early 1993. From a total of 28,855 cases registered in these districts, 26,113 (90.5%) were examined and 18,008 (69.9%) deleted. The deleted included patients who had died, emigrated, double (or occasionally treble) entries for the same patient and those in whom careful re-assessment suggested that the original diagnosis of leprosy had been wrong. In addition, however, 8,260 (45.8%) of the 18,008 cases deleted were considered to have been cured by dapsone monotherapy. This figure, from districts with a relatively poor development of services for leprosy control, prompted a retrospective examination of data from the other (more privileged) nine districts. This revealed that from a total of 264,000 patients screened, prior to the implementation of MDT from 1983 onwards, 75,590 (28.6%) were removed from the registers, and that of these, 63,562 (84.0%) were considered to have been cured by dapsone monotherapy. Thus from a total of 93,598 patients removed from registeres in this State since 1983, 71,822 (76.7%) have been assessed as cured by dapsone monotherapy. The significance of this finding and its apparently considerable contribution to the overall reduction in the prevalence of leprosy in Orissa, 1983-1993, is discussed.

Dapsone↗
PubMed1997

Ultrastructure study of experimental cutaneous leishmaniasis before and after Dapsone intake.

Leishmania strain was isolated from a human case of cutaneous leishmaniasis and inoculated into experimental animals. Group of infected animals were given Dapsone, at a dose of 25 mg/kg for 3 weeks. Results showed that infected animals suffered from autoamputation of the inoculated foot pad. On the other hand, those receiving Dapsone showed complete clinical cure. Transmission Electron Microscope of both groups revealed the fine structure of Leishmania amastigotes. Those given Dapsone showed considerable reversible changes which didn't affect parasitic virulence. This latter has been demonstrated by their ability to infect experimental animals. leading to pathological lesion. It should be pointed out that patients treated with this drug and showed marked clinical response must be very carefully examined for fear of residual parasites which may be the cause of relapse later on.

Adult↗
PubMed1997

[Acute suicidal poisoning with Dapsone].

Course of disease and treatment of 27-years old female patient suffering from celiac disease, who took Dapsone on suicidal purpose in a dose 23 times over maximal daily dose. Methemoglobinemia and hemolysis with anemia typical for this poisoning have been observed. In the first period after intoxication hypokalemia of unknown reason and shedding of hair 7 weeks after intoxication have been noticed. It is remarkable that methemoglobinemia maintained until 8 day after intoxication, in spite of intensive treatment with reducers and blood transfusions. That indicates tissular accumulation of Dapsone. Patient treated with Dapsone shouldn't possess the quantity of this drug that-taken as a single dose-can put him at risk.

Adult↗
PubMedDate not supplied

Cross-reactivity in HIV-infected patients switched from trimethoprim-sulfamethoxazole to dapsone.

STUDY OBJECTIVE: To evaluate the cross-reactivity of dapsone after a documented hypersensitivity reaction to trimethoprim-sulfamethoxazole (TMP-SMX) during prophylaxis for Pneumocystis carinii pneumonia. DESIGN: Retrospective, chart review, cohort study. SETTING: Two university-affiliated teaching hospitals. PATIENTS: Sixty patients infected with the human immunodeficiency virus. MEASUREMENTS AND MAIN RESULTS: Thirteen patients (21.7%) had cross-reactivity to dapsone after the reaction to TMP-SMX. No significant risk factors for this response were identified. Most reactions were of mild or moderate severity and rated as possibly or probably caused by one of the agents. Of the 13 patients, 4 (30.8%) continued therapy. CONCLUSIONS: Although cross-reactivity can occur, dapsone may be considered in patients with mild hypersensitivity reactions to TMP-SMX.

Adult↗
PubMed1998

Role of lipid peroxidation in dapsone-induced hemolytic anemia.

Dapsone hydroxylamine (DDS-NOH) is a direct-acting hemolytic agent responsible for dapsone-induced hemolytic anemia in the rat. The hemolytic activity of DDS-NOH is associated with the formation of disulfide-linked hemoglobin adducts on membrane skeletal proteins. We have postulated that this membrane protein "damage" is a consequence of DDS-NOH-induced oxidative stress within the red cell and that it serves as the trigger for premature removal of injured but intact red cells from the circulation by splenic macrophages. Oxidative stress has also been associated with the induction of lipid peroxidation, and it is possible that direct damage to the lipoidal membrane may play a role in the premature sequestration of the damaged cells in the spleen. To investigate this possibility, rat and human red cells were incubated with hemolytic concentrations of DDS-NOH and examined for evidence of lipid peroxidation using two independent assays: thiobarbituric acid-reactive substances formation and cis-paranaric acid degradation. Phenylhydrazine, which is known to induce lipid peroxidation in red cells, was used as a positive control. The extent of thiobarbituric acid-reactive substances formation and cis-paranaric acid degradation in DDS-NOH-treated rat and human red cells was not significantly different from that in control cells. In contrast, thiobarbituric acid-reactive substances formation and cis-paranaric acid degradation were significantly increased in red cells treated with hemolytic concentrations of the positive control, phenylhydrazine. These data suggest that lipid peroxidation is not involved in the mechanism underlying dapsone-induced hemolytic anemia.

Anemia, Hemolytic↗
PubMed1976

Relapsing polychondritis treated with dapsone.

Relapsing polychondritis is a rare and sometimes fatal disease of unknown cause and pathogenesis. Results of recent studies suggest that it is an immune disorder probably caused by the production of autoantibodies to possibly the mucopolysaccharides. Perpetuation of the cartilage inflammation may be maintained by a proteolytic process. Treatment primarily has been with orally given corticosteroids. Dapsone has been shown to possibly inhibit lysosomal enzyme activity. We present a patient who, to our knowledge, is the first with relapsing polychondritis to be treated successfully with dapsone. The rapid response of the patient's condition to treatment with dapsone suggests an alternative, if not preferred, method of controlling this disease.

Dapsone↗
PubMedDate not supplied

Sulphonamide and dapsone residues in bovine milk following intramammary infusion.

The elimination into bovine milk of sulphonamides (sulphadimidine and sulphamethoxypyridazine) and dapsone following intramammary infusion was studied. Determination of sulphonamides and dapsone in milk was performed by a high performance liquid chromatographic method with UV detection. The limit of quantification was 0.01 microgram/ml. Withdrawal times were established considering the maximum residue limits fixed by the European Community (100 micrograms/kg for sulphonamides and 25 micrograms/kg for dapsone). The diffusion of residues into milk from a quarter infused by the intramammary route to the untreated quarters was also studied.

Animals↗
PubMedDate not supplied

[Acute dapsone exposure and methemoglobinemia in children: treatment with multiple doses of activated charcoal with or without the administration of methylene blue]

OBJECTIVE: To study the changes in methemoglobinemia of 17 children admitted with acute exposure to dapsone complicated by a methemoglobin concentration greater than 20% of the total hemoglobin. The children were treated with multiple doses of activated charcoal with or without the administration of methylene blue.PATIENTS AND METHODS: Seventeen patients (ages 1-13 y, median 3 y), were admitted 1-72 h after the ingestion of 100-1200 mg (median 350 mg, 10 patients) or an unknown amount of dapsone (7 patients). The methemoglobin blood concentrations upon admission ranged from 23.5%-49.7% (median 37.8%), and the main clinical features were cyanosis (17), tachycardia (17), vomiting (11) and tachypnea (8). All of the children received multiple doses of activated charcoal orally or via nasogastric tube (1g/kg, 10% solution, 4-6 times/day, 3-16 doses with a median of 8 doses). Twelve of the 14 patients with methemoglobin levels greater than 30% were also treated with a single dose of methylene blue (1-2% solution, 1-2 mg/kg) infused IV over 5 min.RESULTS: There was a progressive decrease in the methemoglobin levels after the beginning of both treatments (multiple doses of activated charcoal alone or associated with methylene blue), and only one dose of methylene blue was necessary. There were no significant statistical differences between the results of the two treatments according to the time-course decrease in methemoglobinemia (p=0.49 Wilcoxon test).CONCLUSIONS: Multiple doses of activated charcoal given when methemoglobin levels were greater than 20% can be considered as a possible treatment for pediatric patients, with or without the administration of methylene blue, after acute dapsone exposure.

Journal Article↗
PubMed2026

A cost-effective conventional endpoint PCR assay for HLA-B*13:01 genotyping to guide personalized dapsone therapy in leprosy in low-resource settings.

BACKGROUND: Dapsone is a drug used to treat leprosy. Dapsone causes a highly morbid and potentially fatal severe drug hypersensitivity reaction (DHS) in 1-3% of leprosy cases. The allele HLA-B*13:01 is a known genetic risk factor for DHS. However, resource-intensive genotyping methods preclude its testing in resource-limited settings. This study aimed to develop an endpoint PCR assay to detect the presence of HLA-B*13:01. RESEARCH DESIGN AND METHODS: DNA was extracted from blood samples of leprosy patients at Anandaban Hospital, Nepal (2022-24). A duplex endpoint PCR was optimized and validated against a previously validated commercial qPCR method and NGS (next‑generation sequencing). RESULTS: In 113 samples, duplex PCR showed 100% (95% CI: 79.4-100%) sensitivity and 100% specificity (95% CI: 96.2-100%) compared to the validated qPCR method. The same accuracy was confirmed in 58 NGS-typed samples (concordance 98.3%, 95% CI: 90.7-99.9%). The assay reliably differentiated HLA-B*13:01 from closely related allele. Analytical sensitivity reached a lower detection limit of 100 genome equivalents (0.67 ng DNA/reaction). CONCLUSION: The developed duplex endpoint PCR offers a simple and affordable method for detecting HLA-B*13:01, suitable in low-resource settings. Its use may significantly reduce the risk of DHS by guiding safer drug choices prior to MDT initiation.

Humans↗
PubMed1976

Dapsone-induced motor polyneuropathy. A complication of prolonged treatment of subcorneal pustular dermatosis.

A motor polyneuropathy developed in a woman with subcorneal pustular dermatosis of 16 years' duration, who had received at least 300 gm of dapsone over a five-year period and 80 gm during the four-month period of progression of her neurologic symptoms. Although the patient believed her muscle power had returned to normal four months after the drug was stopped, a slight peripheral neuropathy remained. Electrodiagnostic and clinical features during the period of greatest weakness and the subsequent 16 months were consistent with a polyneuropathy of the axonal type. The neurotoxicity of dapsone appears to be dose-dependent, but the mechanism by which it occurs is unknown.

Adult↗
PubMed1981

Dapsone hypersensitivity. The sulfone syndrome revisited.

A hypersensitivity reaction to low-dose (50-mg), short-term dapsone administration developed in a 16-year-old girl. The reaction included fever, malaise, dermatitis, jaundice with hepatic dysfunction, lymphadenopathy, and hemolytic anemia. Physicians should be familiar with this "sulfone syndrome," an uncommon, potentially serious, side effect of dapsone therapy.

Acne Vulgaris↗
PubMed2001

Comparison between intravenous immunoglobulin and conventional immunosuppressive therapy regimens in patients with severe oral pemphigoid: effects on disease progression in patients nonresponsive to dapsone therapy.

CONTEXT: Mucous membrane pemphigoid has a wide clinical spectrum. The clinical context was to determine whether pemphigoid disease that initiates in the oral cavity progresses to involve other mucosae and to determine the influence of systemic therapy on such progression. OBJECTIVE: To determine the clinical outcomes and disease progression in patients with oral pemphigoid for whom dapsone therapy was impossible. DESIGN: Retrospective analysis of a cohort of 20 patients with immunopathologic-proven oral pemphigoid studied between September 1, 1994, and October 31, 2000. Twelve patients received conventional therapy that consisted of a combination of oral prednisone with an immunosuppressive agent. Eight patients in whom such therapy was contraindicated received intravenous immunoglobulin therapy. Patients were followed up for 33 to 62 months (mean follow-up, 47.5 months). SETTING: Patients were treated in an ambulatory tertiary medical care facility of a university-affiliated hospital. PATIENTS: The 20 patients had pemphigoid disease limited to the oral cavity only at the initial clinical presentation and when enrolled in the study. MAIN OUTCOME MEASURES: The following variables were compared between the 2 groups of patients: (1) duration of treatment, (2) frequency of relapses, (3) induction of remission, (4) adverse effects of therapy, (5) extra oral involvement, and (6) quality of life. RESULTS: Using the aforementioned factors, the group treated with intravenous immunoglobulin had statistically significant shorter treatment duration, fewer relapses, higher remission rate, fewer adverse effects, no extraoral involvement, and a better quality of life compared with the group who received conventional therapy. CONCLUSIONS: Intravenous immunoglobulin is a safe and effective modality to treat mucous membrane pemphigoid. It seems to be a good option for patients who cannot be treated with dapsone and in whom conventional therapy is contraindicated or results in the development of serious adverse effects. In patients with progressive mucous membrane pemphigoid, intravenous immunoglobulin therapy may arrest disease progression.

Adult↗
PubMed1977

Contaminants in commercial dapsone.

Three contaminants commonly found in commercial dapsone were identified as 2,4'-sulfonylbis(benzeneamine), 4-(phenylsulfonyl)benzeneamine, and 4-(4'-chlorophenylsulfonyl)benzeneamine. The identities were based on the spectral analysis and unambiguous synthesis of each compound. Solvent-free, pure dapsone was prepared by recrystallization from chloroform.

Chemical Phenomena↗
PubMed1985

Binding of dapsone and its analogues to human serum albumin.

The binding of dapsone, 4,4'-sulfonylbis(aniline)(1), and its diacetylated derivative, 4,4"'-sulfonylbis(acetanilide)(2), to human serum albumin is reported. To assess the ability of these compounds to displace 4'-[(4-aminophenyl)sulfonyl]acetanilide (3) from albumin, a dialysis rate technique was used. Competition for the bilirubin binding site on albumin was measured with the peroxidase assay. Compounds 1 and 2 strongly displaced both 3 and bilirubin from human serum albumin. The association constants for 1 and 2 with respect to bilirubin binding were 1.29 X 10(3) and 1.15 X 10(4) M-1, respectively. These results suggest that the binding site for 3 and the bilirubin binding site are similar with respect to 1 and 2 and that the binding of dapsone and its derivatives probably does not involve the amino function.

Dapsone↗
PubMed1982

Peripheral motor neuropathy caused by excessive intake of dapsone (Avlosulfon).

A case of selective peripheral motor polyneuropathy caused by excessive intake of dapsone is described. The condition was characterized by a peripheral muscle weakness in all limbs, normal sensitivity and present, although weak, muscle reflexes. Neurophysiologically, low amplitude muscle responses, prolonged distal latencies and reduced motor conduction velocities were found together with electromyographic signs of denervation. Sensory neurography was normal. The patient showed a complete clinical recovery and a marked neurophysiological restitution after termination of the excessive drug intake. The patient was found to acetylate dapsone at a slow rate. The case is compared with those previously reported in the literature.

Adult↗
PubMed1984

Acantholysis produced in vitro with pemphigus serum: hydrocortisone inhibits acantholysis, while dapsone and 6-mercaptopurine do not inhibit acantholysis.

Many studies have shown that human skin in organ cultures containing pemphigus antibody undergoes acantholysis, the histologic hallmark of pemphigus vulgaris. This in vitro organ culture system provides a good model to determine if drugs used to treat pemphigus inhibit the effect of pemphigus antibody after it is produced. In this study we determined if hydrocortisone, dapsone, and 6-mercaptopurine (6-MP) could inhibit acantholysis observed in human skin organ cultures containing high constant levels of pemphigus plasma. In six experiments we demonstrated that hydrocortisone (10(-3) and 5 X 10(-4) M) present at the start of organ culture inhibited acantholysis induced by pemphigus sera. Thus, this study raises the possibility that the large doses of steroids used to treat acute pemphigus could act directly on the skin, inhibiting acantholysis in the presence of high titers of pemphigus antibody. Other effective immunosuppressive drugs, such as dapsone and 6-MP, probably do not act directly on the skin.

Acantholysis↗