Hemolytic anemia incident in leprosy patients receiving multi-drug therapy at Haji Adam Malik Central Hospital, Medan-Indonesia.

Introduction: Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae ,which is an obligate intracellular bacteria. The therapy of leprosy involves a combination of drugs called multi-drug therapy and one of the drugs included in this therapy is dapsone. Dapsone has a hematotoxic effect because of its toxic metabolite called hydroxilamine. The most common side effect of this drug is hemolytic anemia. Hemolytic anemia occurs when the production of erythrocytes is not balanced with their destruction, causing the lifespan of erythrocyte to become shorter and the bone marrow fails to compensate for this.

Methods: This research is a pre experimental study with a pre-post design, involving 15 leprosy patients that were diagnosed by clinical and laboratory examination. We conducted measurements of hemoglobin, MCV, MCHC, and reticulocyte count before and after the MDT therapy for 3 months.

Results: In this study, the incidence of hemolytic anemia after 3 months receiving MDT was 66.7%. There was decreased hemoglobin level (mean 11.320 g/dl), increased reticulocyte count (mean 2.341%), normal level of MCV (mean 88.807 fL), and decreased level of MCHC (mean 31.920 g%). There were significant differences in hemoglobin level, MCHC level, and reticulocyte count before and after 3 moths of MDT.

Conclusion: There was a significant difference in the number of hemolytic anemia before and after MDT with a p-value < 0.05.