Skip to main content
Top
Published in: Journal of Medical Case Reports 1/2011

Open Access 01-12-2011 | Case report

Dapsone-induced agranulocytosis leading to perianal abscess and death: a case report

Authors: Yoshiro Kobe, Daisuke Setoguchi, Nobuya Kitamura

Published in: Journal of Medical Case Reports | Issue 1/2011

Login to get access

Abstract

Introduction

Dapsone (diaminodiphenylsulfone) is used for the treatment of intractable skin diseases such as pemphigus and leprosy. The side effects of Dapsone are anemia, leukopenia, and liver dysfunction. Here, we present a case of agranulocytosis-induced septic shock, which was a side effect of Dapsone.

Case presentation

An 82-year-old Japanese woman was transferred to our hospital with fever, leucopenia, and respiratory arrest. At the previous hospital, she had been administered Dapsone for linear IgA bullous dermatosis. At the time of admission, she presented with methemoglobinemia and septic shock, which was due to immunosuppression caused by the normal dose of Dapsone. Although her overall health initially improved, her condition deteriorated because of septic shock caused by an anal fistula. She died of sepsis on hospital day 80.

Conclusion

One of the side effects of Dapsone is agranulocytosis. Patients with agranulocytosis may be in danger of developing anal fistula. Therefore, care must be taken if a patient with agranulocytosis develops a decubitus ulcer in the sacral region, since it could develop into a fistula-in-ano.
Appendix
Available only for authorised users
Literature
1.
go back to reference Coleman MD: Dapsone-mediated agranulocytosis: risks, possible mechanisms and prevention. Toxicology. 2001, 162: 53-60. 10.1016/S0300-483X(01)00360-2.CrossRefPubMed Coleman MD: Dapsone-mediated agranulocytosis: risks, possible mechanisms and prevention. Toxicology. 2001, 162: 53-60. 10.1016/S0300-483X(01)00360-2.CrossRefPubMed
2.
go back to reference Zuidema J, Hilbers-Modderman ES, Merkus FW: Clinical pharmacokinetics of Dapsone. Clin Pharmacokinet. 1986, 11: 299-315. 10.2165/00003088-198611040-00003.CrossRefPubMed Zuidema J, Hilbers-Modderman ES, Merkus FW: Clinical pharmacokinetics of Dapsone. Clin Pharmacokinet. 1986, 11: 299-315. 10.2165/00003088-198611040-00003.CrossRefPubMed
4.
go back to reference Trillo RA, Aukburg S: Dapsone-induced methemoglobinemia and pulse oximetry. Anesthesiology. 1992, 77: 594-596. 10.1097/00000542-199209000-00029.CrossRefPubMed Trillo RA, Aukburg S: Dapsone-induced methemoglobinemia and pulse oximetry. Anesthesiology. 1992, 77: 594-596. 10.1097/00000542-199209000-00029.CrossRefPubMed
5.
go back to reference Schimpff SC, Wiernik PH, Block JB: Rectal abscesses in cancer patients. Lancet. 1972, 300: 844-847. 10.1016/S0140-6736(72)92210-6.CrossRef Schimpff SC, Wiernik PH, Block JB: Rectal abscesses in cancer patients. Lancet. 1972, 300: 844-847. 10.1016/S0140-6736(72)92210-6.CrossRef
6.
go back to reference Sehdev MK, Dowling MD, Seal SH, Stearns MW: Perianal and anorectal complications in leukemia. Cancer. 1973, 31: 149-152. 10.1002/1097-0142(197301)31:1<149::AID-CNCR2820310120>3.0.CO;2-F.CrossRefPubMed Sehdev MK, Dowling MD, Seal SH, Stearns MW: Perianal and anorectal complications in leukemia. Cancer. 1973, 31: 149-152. 10.1002/1097-0142(197301)31:1<149::AID-CNCR2820310120>3.0.CO;2-F.CrossRefPubMed
7.
go back to reference Vanhueverzwyn R, Delannoy A, Michaux JL, Dive C: Anal lesions in hematologic diseases. Dis Colon Rectum. 1980, 23: 310-312. 10.1007/BF02586835.CrossRefPubMed Vanhueverzwyn R, Delannoy A, Michaux JL, Dive C: Anal lesions in hematologic diseases. Dis Colon Rectum. 1980, 23: 310-312. 10.1007/BF02586835.CrossRefPubMed
8.
go back to reference Rickard MJ: Anal abscesses and fistulas. ANZ J Surg. 2005, 75: 64-72. 10.1111/j.1445-2197.2005.03280.x.CrossRefPubMed Rickard MJ: Anal abscesses and fistulas. ANZ J Surg. 2005, 75: 64-72. 10.1111/j.1445-2197.2005.03280.x.CrossRefPubMed
9.
go back to reference Marcus RH, Stine RJ, Cohen MA: Perirectal abscess. Ann Emerg Med. 1995, 25: 597-603. 10.1016/S0196-0644(95)70170-2.CrossRefPubMed Marcus RH, Stine RJ, Cohen MA: Perirectal abscess. Ann Emerg Med. 1995, 25: 597-603. 10.1016/S0196-0644(95)70170-2.CrossRefPubMed
Metadata
Title
Dapsone-induced agranulocytosis leading to perianal abscess and death: a case report
Authors
Yoshiro Kobe
Daisuke Setoguchi
Nobuya Kitamura
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2011
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-5-107

Other articles of this Issue 1/2011

Journal of Medical Case Reports 1/2011 Go to the issue