02258nas a2200301   4500000000100000008004100001260001700042653001000059653001600069653001200085653002600097653003000123653001100153653001100164653002300175653001200198653001300210653001300223100001700236700001500253700001400268700001600282245009100298300001000389490000700399520153600406022001401942       2004                            d  c2004 Nov-Dec10aChild10aClofazimine10aDapsone10aDrug Hypersensitivity10aDrug Therapy, Combination10aFemale10aHumans10aLeprostatic Agents10aleprosy10aRifampin10aSyndrome1 aBucaretchi F1 aVicente DC1 aPereira R1 aTresoldi AT00aDapsone hypersensitivity syndrome in an adolescent during treatment during of leprosy.  a331-40 v463 a<p>A 12 y old girl was admitted 24 days after start a WHO multidrug therapy scheme for multibacillary leprosy (dapsone, clofazimine and rifampicin) with intense jaundice, generalized lymphadenopathy, hepatoesplenomegaly, oral erosions, conjunctivitis, morbiliform rash and edema of face, ankles and hands. The main laboratory data on admission included: hemoglobin, 8.4 g/dL; WBC, 15,710 cells/mm3; platelet count, 100,000 cells/mm3; INR = 1.49; increased serum levels of aspartate and alanine aminotransferases, gamma-glutamyl transpeptidase, alkaline phosphatase, direct and indirect bilirubin. Following, the clinical conditions had deteriorated, developing exfoliative dermatitis, shock, generalized edema, acute renal and hepatic failure, pancytopenia, intestinal bleeding, pneumonia, urinary tract infection and bacteremia, needing adrenergic drugs, replacement of fluids and blood product components, and antibiotics. Ten days after admission she started to improve, and was discharged to home at day 39th, after start new supervised treatment for leprosy with clofazimine and rifampicin, without adverse effects. This presentation fulfils the criteria for the diagnosis of dapsone hypersensitivity syndrome (fever, generalized lymphadenopathy, exfoliative rash, anemia and liver involvement with mixed hepatocellular and cholestatic features). Physicians, mainly in geographical areas with high prevalence rates of leprosy, should be aware to this severe, and probably not so rare, hypersensitivity reaction to dapsone.</p>  a0036-4665