Dapsone‐induced agranulocytosis—possible involvement of low‐activity N‐acetyltransferase 2 |
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| Authors: | Ines Poto?njak Iveta ?imi? Danica Juri?i? Nahal Ivana ?egec Lana Ganoci Nada Bo?ina |
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| Institution: | 1. Clinical Unit of Clinical Pharmacology and Toxicology, Department of Medicine, University Hospital Centre Sisters of Charity, Zagreb, CroatiaEqually contributing first authors.;2. University of Zagreb School of Medicine, Zagreb, Croatia;3. Division of Clinical Pharmacology, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia;4. Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia |
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| 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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| Keywords: | adverse drug reactions agranulocytosis dapsone glucose‐6‐phosphate dehydrogenase NAT2 *5/*6 |
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