A case of dapsone-induced haemolytic anaemia without glucose-6-phosphate dehydrogenase deficiency : “mind the bite”

Abstract

INTRODUCTION: Some drugs induce haematotoxicity as a consequence of increased oxidant stress, especially in susceptible patients, namely those with glucose-6-phosphate dehydrogenase deficiency. Less commonly, it occurs in non-deficient individuals, as we report in this case.

CASE REPORT: A patient with a dermatological condition (and multiple comorbidities), being treated with dapsone, is hospitalized due to sepsis with multiorgan dysfunction, including anaemia and thrombocytopaenia. After a good initial response, the haematological dysfunction worsens, suggesting more contributing factors other than the initial septic insult.

CONCLUSION: It is essential to establish a broad evaluation of each patient, considering a careful review of their past medical history, multiple comorbidities and associated medications. A multidisciplinary discussion can assist in better diagnosis and follow-up of patients. In this particular case, the peripheral blood smear and biochemistry findings were crucial clues to establish the diagnosis.