Year: 2025 | Month: December | Volume: 12 | Issue: 12 | Pages: 245-247
DOI: https://doi.org/10.52403/ijrr.20251226
When Dapsone Turns Dangerous: A Case of Life Threatening Agranulocytosis in Leprosy Treatment
Spandana R Godi1, Rosch Ha Shanna G Kharmalki1, Shubham B Harapanahalli1, Jeevan KG1, Ashily Panicker1, Hannah Mary Biju1
1Pharm D Interns, Department of Pharmacy Practice, Bapuji College of Pharmacy, Davanagere, Karnataka, India-577004,
Corresponding Author: Spandana R Godi
ABSTRACT
Dapsone-induced agranulocytosis is a rare but potentially life-threatening complication in patients receiving multidrug therapy for leprosy. In individuals receiving dapsone therapy, a prevalence of 0.2-0.4% has been reported. A 32-year-old leprosy patient developed dapsone-induced agranulocytosis with fever, pancytopenia, and splenomegaly. Dapsone was stopped; he was treated with antibiotics, antipyretics, antifungals, antivirals, antimalarials, and supportive care. A 32-year-old male with leprosy on multidrug therapy presented with 8 days of high-grade fever, throat pain, and vomiting. Examination revealed pallor, tachycardia (132 bpm), and hypotension (80/60 mmHg). Labs showed severe pancytopenia with agranulocytosis (TLC 280/mm³), anemia (Hb 5.8 g/dL), thrombocytopenia, elevated CRP (266.54 mg/L), and mild splenomegaly. Dapsone-induced agranulocytosis was diagnosed. He was treated with broad-spectrum antibiotics (Cefoperazone-sulbactam, Piperacillin-tazobactam), and dapsone was discontinued. MDT continued with rifampicin and clofazimine. Supportive care included analgesics, antipyretics, antifungals, antimalarials, antivirals, and a single dose of pheniramine to manage suspected allergic reactions. This case highlights that early recognition and drug withdrawal are crucial for effective management and patient recovery.
Keywords: Dapsone-induced agranulocytosis, Leprosy, Pancytopenia, Multidrug therapy (MDT), Broad-spectrum antibiotics.
[PDF Full Text]