Haemolytic anaemia dapsone

Ranawaka RR, Mendis S, Weerakoon HS. Dapsone-induced haemolytic anaemia, hepatitis and agranulocytosis in a leprosy patient with normal glucose-6-phosphate-dehydrogenase activity. Lepr Rev 2008 79 (4) 436 0. 

Treatment involves withdrawal of the causative drug and supportive measures. Many cases are self-limiting however, severe cases may require systemic steroids. Subjects with A type of G6PD deficiency can no longer be regarded as mild variants as these subjects too can have a life-threatening form of dapsone-induced acute haemolytic anaemia, as shown by Pamba A et al. [76 ]. 

Hyperbilirubinaemia Symptomatic hyperbilirubinaemia due to haemolytic anaemia is a potential adverse event when using the combination of atazanavir and dapsone (for pneumocystis jirovecii pneumonia prophylaxis) in the treatment of patients with HIV [78 ]. Symptoms and laboratory evidence of haemolysis resolved upon discontinuation of dapsone, enabling successful antiretroviral therapy. 

A useful review of the adverse effects of Dapsone by Graham (55 ) considered its potential for producing haemolytic anaemia and methaemogjobinaemia in some detail. Particular attention was paid to the role played by G6PD deficiency. 

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