A Review on Dapsone Hypersensitivity Syndrome Among Chinese Patients with an Emphasis on Preventing Adverse Drug Reactions with Genetic Testing.
AbstractDapsone is a bactericidal and bacteriostatic againstMycobacterium leprae, a causative agent of leprosy. Dapsone is also applied in a range of medical fields because of its anti-inflammatory and immunomodulatory effects. Dapsone hypersensitivity syndrome (DHS) is a rare yet serious adverse drug reaction (ADR) caused by dapsone involving multiple organs. We performed a systematic review of published articles describing dapsone-induced hypersensitivity syndrome, including all Chinese articles and the latest literature available in online databases published between October 2009 and October 2015. We determined the prevalence, clinical characteristics, and mortality rate of DHS. Importantly, we also summarized the recent advances in genetic testing allowing prediction of ADRs. In an initial systematic electronic search, we retrieved 191 articles. Subsequently, these articles were further filtered and ultimately 84 articles (60 Chinese case reports, 21 non-Chinese articles, and three epidemiological studies) were selected, which included 877 patients. The prevalence of DHS among Chinese patients was 1.5% with a fatality rate of 9.6%. Early withdrawal of dapsone and appropriate treatment reduced the fatality rate. Most importantly, genetic screening for the HLA-B*13:01 allele among high-risk populations showed a significant utility as a useful genetic marker to DHS. In conclusion, this review discusses the epidemiological and clinical characteristics of DHS among Chinese patients, which may help physicians to understand this syndrome.
Department of Dermatology, Shandong Provincial Hospital for Skin Disease, Shandong University, Jinan, China.|Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China.|Department of Dermatology and Venereology, Shandong Provincial Institute of Dermatology and Venereology, Shandong University, Jinan, China.|Shandong Provincial Medical Center for Dermatovenereology, Jinan, Shandong, China.
Na
N
Wang
Department of Dermatology and Venereology, Shandong Provincial Institute of Dermatology and Venereology, Shandong University, Jinan, China.|Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China.
Leela
L
Parimi
Department of Dermatology and Venereology, Shandong Provincial Institute of Dermatology and Venereology, Shandong University, Jinan, China.|Department of Dermatology, Shandong Provincial Hospital for Skin Disease, Shandong University, Jinan, China.|Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China.|Shandong Provincial Medical Center for Dermatovenereology, Jinan, Shandong, China.
Hong
H
Liu
Department of Dermatology and Venereology, Shandong Provincial Institute of Dermatology and Venereology, Shandong University, Jinan, China.|Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China.|Shandong Provincial Medical Center for Dermatovenereology, Jinan, Shandong, China.|Department of Dermatology, Shandong Provincial Hospital for Skin Disease, Shandong University, Jinan, China.
Furen
F
Zhang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000483:Alleles; D002648:Child; D002681:China / Q000453:epidemiology; D003622:Dapsone / Q000008:administration & dosage / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D057915:Drug Substitution / Q000706:statistics & numerical data; D005260:Female; D005820:Genetic Testing / Q000379:methods*; D059908:HLA-B13 Antigen / Q000235:genetics* / Q000276:immunology; D006801:Humans; D007917:Leprostatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D007918:Leprosy / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009166:Mycobacterium leprae / Q000187:drug effects; D015995:Prevalence; D011322:Primary Prevention / Q000379:methods; D016019:Survival Analysis; D013577:Syndrome
D059908:HLA-B13 Antigen; D007917:Leprostatic Agents; D003622:Dapsone