Korean J Pediatr.  2013 Jun;56(6):260-264.

Severe dapsone hypersensitivity syndrome in a child

• Choi SY
• Hwang HY
• Lee JH
• Park JS
• Jang MS

Abstract

Dapsone (4,4'-diaminodiphenylsulfone, DDS), a potent anti-inflammatory agent, is widely used in the treatment of leprosy and several chronic inflammatory skin diseases. Dapsone therapy rarely results in development of dapsone hypersensitivity syndrome, which is characterized by fever, hepatitis, generalized exfoliative dermatitis, and lymphadenopathy. Here, we describe the case of an 11-year-old Korean boy who initially presented with high fever, a morbilliform skin rash, generalized lymphadenopathy, hepatosplenomegaly, and leukopenia after 6 weeks of dapsone intake. Subsequently, he exhibited cholecystitis, gingivitis, colitis, sepsis, aseptic meningitis, disseminated intravascular coagulation, syndrome of inappropriate antidiuretic hormone secretion, pneumonia, pleural effusions, peritonitis, bronchiectatic changes, exfoliative dermatitis, and acute renal failure. After 2 months of supportive therapy, and prednisolone and antibiotic administration, most of the systemic symptoms resolved, with the exception of exfoliative dermatitis and erythema, which ameliorated over the following 4 months. Agranulocytosis, atypical lymphocytosis, aseptic meningitis, and bronchiectatic changes along with prolonged systemic symptoms with exfoliative dermatitis were the most peculiar features of the present case.

Keyword

Aseptic meningitis; Bronchiectasis; Dapsone; Multiple organ failure

MeSH Terms

Acute Kidney Injury
Agranulocytosis
Bronchiectasis
Child
Cholecystitis
Colitis
Dapsone
Dermatitis, Exfoliative
Disseminated Intravascular Coagulation
Erythema
Exanthema
Fever
Gingivitis
Hepatitis
Humans
Hypersensitivity
Leprosy
Leukopenia
Lymphatic Diseases
Lymphocytosis
Meningitis, Aseptic
Multiple Organ Failure
Peritonitis
Pleural Effusion
Pneumonia
Prednisolone
Sepsis
Skin Diseases
Dapsone
Prednisolone