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Dapsone-induced agranulocytosis-possible involvement of low-activity N-acetyltransferase 2
Ines Potočnjak1, Robert Likić2,3, Iveta Šimić2,3
1Clinical Unit of Clinical Pharmacology and Toxicology, Department of Medicine, University Hospital Centre Sisters of Charity, Vinogradska cesta, 10 000, Zagreb, Croatia.
Abstract:
Dapsone-induced agranulocytosis is a rare but potentially fatal adverse drug reaction (ADR). A 45-year-old male Caucasian patient developed agranulocytosis caused by dapsone (diamino-diphenyl sulfone), which he was prescribed for leukocytoclastic vasculitis. Patient's treatment consisted of termination of dapsone, antibiotic therapy, and granulocyte colony-stimulating factor leading to prompt improvement of symptoms and normalization of laboratory blood values. Diagnostic evaluation revealed methemoglobinemia and excluded glucose-6-phosphate dehydrogenase deficiency. Pharmacogenetics testing showed that he was a carrier of NAT2 *5/*6 genotype, predisposing to low activity of the N-acetyltransferase 2 enzyme. This was the first and only ADR to dapsone reported in Croatia. In total, there have been 73 ADR to dapsone recorded worldwide, including only four cases of agranulocytosis.
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