Severe dapsone hypersensitivity syndrome in a child.

Area of Science:

• Dermatology
• Internal Medicine
• Pharmacology

Background:

• Dapsone (4,4'-diaminodiphenylsulfone) is an anti-inflammatory drug used for leprosy and inflammatory skin conditions.
• Dapsone hypersensitivity syndrome is a rare but serious adverse reaction.
• The syndrome typically presents with fever, hepatitis, exfoliative dermatitis, and lymphadenopathy.

Purpose of the Study:

• To describe a unique case of dapsone hypersensitivity syndrome in a pediatric patient.
• To highlight the atypical and prolonged systemic manifestations observed.

Main Methods:

• Case report of an 11-year-old Korean boy.
• Detailed clinical observation and documentation of symptoms and disease progression.
• Review of treatment response to supportive care, prednisolone, and antibiotics.

Main Results:

• The patient developed high fever, rash, lymphadenopathy, and leukopenia after 6 weeks of dapsone.
• Subsequent severe complications included cholecystitis, sepsis, aseptic meningitis, DIC, SIADH, pneumonia, and acute renal failure.
• Peculiar features included agranulocytosis, atypical lymphocytosis, aseptic meningitis, bronchiectatic changes, and prolonged exfoliative dermatitis.

Conclusions:

• Dapsone hypersensitivity syndrome can present with a wide spectrum of severe systemic involvement.
• Aseptic meningitis and bronchiectatic changes represent unusual manifestations.
• Prompt supportive care and corticosteroid treatment can lead to symptom resolution, though some dermatological effects may persist.