title: [Disulone and hepatosiderosis].
abstract: BACKGROUND
  Disulone (dapsone + iron oxalate) is a sulfone used in the treatment of numerous skin diseases. We report two cases of hepatosiderosis secondary to long-term administration of Disulone.
  
  
  METHODS
  Case n degrees 1. A 51-year-old man was treated with Disulone for a neutrophilic skin disease. After 17 years of treatment, elevated serum ferritin and free iron with hemolysis were found. Liver biopsy confirmed hepatosiderosis. A diagnosis of genetic hemochromatosis was ruled out by the absence of C282Y mutation of the HFE gene. Case n degrees 2. A 52-year-old man receiving Disulone for dermatitis herpetiformis for 25 years presented elevated serum ferritin and free iron with hemolysis. Hepatic iron overload was confirmed by liver biopsy. The absence of C282Y mutation (HFE gene) ruled out a diagnosis of genetic hemochromatosis.
  
  
  CONCLUSIONS
  In our two cases, hepatosiderosis was noted after long-term administration of Disulone. This complication has been reported only rarely. In murine models, a relationship was found between prolonged administration of dapsone and hepatic iron overload as revealed by hemolysis. Although it is difficult to extrapolate this relationship to humans with any certainty, our patients had also chronic hemolysis and iron overload secondary to administration of Disulone. Moreover in France, dapsone is marketed in combination with iron oxalate, with the attendant risk of iron overload. These cases raise the question of the need for serum ferritin analysis during Disulone therapy.
authors.affiliation: Service de Dermatologie, CHU Pontchaillou, Cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Darrieux
authors.forename: H
authors.initials: H
authors.lastname: Adamski
authors.forename: B
authors.initials: B
authors.lastname: Turlin
authors.forename: I
authors.initials: I
authors.lastname: Ollivier
authors.forename: E
authors.initials: E
authors.lastname: Polard
authors.forename: Y
authors.initials: Y
authors.lastname: Deugnier
authors.forename: J
authors.initials: J
authors.lastname: Chevrant-Breton
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury; D003622:Dapsone / Q000009:adverse effects*; D003874:Dermatitis Herpetiformis / Q000188:drug therapy; D003879:Dermatologic Agents / Q000009:adverse effects*; D005293:Ferritins / Q000097:blood; D006461:Hemolysis / Q000502:physiology; D006486:Hemosiderosis / Q000139:chemically induced*; D006801:Humans; D007501:Iron / Q000097:blood; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D012871:Skin Diseases / Q000188:drug therapy
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D003879:Dermatologic Agents; D003622:Dapsone; D005293:Ferritins; D007501:Iron