DAPSONE HYPERSENSITIVITY SYNDROME IN LEPROSY Zakiyah Salim ,Maya Milani B, St.Musai!ah, Diana"aty A, Ratna #$mala D, Muh.Dali Ami!u%%in , &a!i%ha S Ilyas, S!i Vitayani M D'!mat$(V'n'!'$l$)y D'*a!tm'nt, M'%i+al &a+ulty $ Hasanu%%in ni-'!sity D!./ahi%in Su%i!$hus$%$ 0'n'!al H$s*ital, Makassa!, In%$n'sia ABSTRACT Background: Da*s$n' Hy*'!s'nsiti-ity Syn%!$m' 1DHS2 is a !a!' "'ll !'+$)n s'!i$us a%-'!s' ''+t +ha!a+t'!i3'% 4y '-'!, skin !ash's, )'n'!ali3'% lym*ha%' h'*atitis an% h'*at$(s*l'n$m')aly. Hi*'!s'nsiti-ity !'a+ti$n $++u! %u!in) i!st 5 "''ks, 4ut +an $++u! at'! 5 m$nths. Objective 6 t$ in% $ut th' t$tal +as's $! 7 y'a!s $ %a*s$n hy*'!s'nsiti-ity syn th' "ahi%in su%i!$hus$%$ )'n'!al h$s*ital, Makassa!, In%$n'sia. Method: A !'t!$s*'+ti-' stu%y "as +a!!i'% $ut tak'n !$m m'%i+al!'+$!%an% !')ist!ati$n 4$$k. 18anua!y 799:( D'+'m4'! 79952 Result 6 &i-' *ati'nts "ith %a*s$n hy*'!s'nsiti-ity syn%!$m' "'!' !'*$!t'%. All *a !'+'i-'% %a*s$n' as a *a!t $ MDT $! l'*!$sy. &'-'!, ;aun%i+', skin l'si$n "'!' in : +as's, 4ut < +as' a**'a!an+' lik' m$!4ili$!m. Lym*ha%'n$*athy 17 +as's2, s*l'n$m')aly an% a+ut *sy+h$sis 1< +as'2. La4$!at$!y %ata $n a%missi$n in+lu%'% h'm$)l$4in,l'u+$+yt$sis, 'l'-at'% l'-'l$ s'!um li-'!'n3ym's, '!yth!$+yt' s'%im'ntati$n, !ais'% 4ili!u4in an% hy*$*!$t'in'mia. Th' int'!-al 4't"''n sta!t $ %a*s$n' th'!a*y an% a**'a!an+' $ sym*t$ms -a!i'% !$m 7(= "''ks. But $n' +as' t +lini+al mani'stati$n $++u! > m$nths at'! +$nsum*ti$n $ Multi %!u) t!'atm'nt1 All +as's "'!' t!'at'% "ith +$!ti+$st'!$i%s at'! "ith%!a"in) %a*s$n', MDT "as +$ntinu'% 4y !'*la+in) %a*s$n' "ith min$+y+lin. Conclusion: Th'!' a!' si)nii+ant +lini+al im*!$-'m'nt in all +as's, su+h as +$m*l !'s$luti$n $ skin l'si$ns an% $th'! sym*t$ms. Key Words 6 Dapsone syndrome , leprosy, multi drug treatment 9

Dapsone Hypersensitivity Syndrome in Leprosy

Download DOC Report

Upload
hafizarqursoy
View
1
Download
0

Embed Size (px)

DESCRIPTION

55555

Citation preview

Abstract

DAPSONE HYPERSENSITIVITY SYNDROME IN LEPROSY

Zakiyah Salim, Maya Milani B, St.Musafirah, Dianawaty A, Ratna Komala D,

Muh.Dali Amiruddin, Faridha S Ilyas, Sri Vitayani M

Dermato-Venereology Department, Medical Faculty of Hasanuddin University/ Dr.Wahidin Sudirohusodo General Hospital, Makassar, Indonesia

ABSTRACT

Background: Dapsone Hypersensitivity Syndrome (DHS) is a rare well recognized serious adverse effect characterized by fever, skin rashes, generalized lymphadenopathy, hepatitis and hepato-splenomegaly. Hipersensitivity reaction occur during first 6 weeks, but can occur after 6 months.

Objective: to find out the total cases for 2 years of dapson hypersensitivity syndrome in the wahidin sudirohusodo general hospital, Makassar, Indonesia.

Method: A retrospective study was carried out taken from medical record and registration book. (January 2005- December 2006)

Result: Five patients with dapson hypersensitivity syndrome were reported. All patients received dapsone as a part of MDT for leprosy. Fever, jaundice, skin lesion were detected in 5 cases, but 1 case appearance like morbiliform. Lymphadenopathy (2 cases), splenomegaly and acut psychosis (1 case). Laboratory data on admission included : low hemoglobin, leucocytosis, elevated level of serum liver enzymes, erythrocyte sedimentation, raised bilirubin and hypoproteinemia. The interval between start of dapsone therapy and appearance of symptoms varied from 2-7 weeks. But one case the clinical manifestation occur 8 months after consumption of Multi drug treatment(MDT).

All cases were treated with corticosteroids after withdrawing dapsone, MDT was continued by replacing dapsone with minocyclin.

Conclusion: There are significant clinical improvement in all cases, such as complete resolution of skin lesions and other symptoms.

Key Words: Dapsone syndrome, leprosy, multi drug treatmentPAGE 1