Dapsone-induced sulfone syndrome.
OBJECTIVE
To report a patient with dapsone-induced sulfone syndrome.


METHODS
A 42-year-old HIV-infected African American man developed fever, lymphadenopathy, exfoliative dermatitis, hepatitis, and methemoglobinemia 4 weeks after starting dapsone. Complete resolution of symptoms and laboratory abnormalities occurred with cessation of dapsone therapy.


CONCLUSIONS
Sulfone syndrome is not a well-known sequela of dapsone therapy. It is not dose-related, usually occurs in doses of 50-300 mg/d, all cases occur within 2 months of starting dapsone, all patients have fever, and most patients will develop rash and evidence of hepatic injury. The temporal relationship between dapsone therapy and onset of clinical symptoms and objective data led us to believe that dapsone caused sulfone syndrome in our patient. An objective causality assessment revealed that the adverse drug event was probable.


CONCLUSIONS
Although sulfone syndrome appears to be relatively uncommon, healthcare practitioners must be aware of the potentially fatal syndrome associated with dapsone use.
Lee
Kimberly B
KB
Antimicrobial Management Team, Department of Pharmacy, Virginia Commonwealth University Health System/Medical College of Virginia Hospitals and Physicians, Richmond, VA, USA. kblee@hsc.vcu.edu
Nashed
Trisha B
TB
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000473:pathology; D003622:Dapsone / Q000009:adverse effects*; D003872:Dermatitis / Q000473:pathology; D005334:Fever / Q000139:chemically induced; D015658:HIV Infections / Q000150:complications; D006801:Humans; D008297:Male; D008708:Methemoglobinemia / Q000139:chemically induced; D013450:Sulfones / Q000009:adverse effects*; D013577:Syndrome
D019380:Anti-HIV Agents; D000890:Anti-Infective Agents; D013450:Sulfones; D003622:Dapsone