A case of dapsone-induced hemolytic anemia related to G6PD enzyme deficiency

Abstract

Hemolytic anemia is characterized by a decrease in the number of circulating erythrocytes due to an increase in their hemolysis. Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common erythrocyte enzyme defects related to hemolysis. The G6PD enzyme abrogates the hemolysis of erythrocytes by protecting them against oxidative stress due to its involvement in the glutathione metabolism. G6PD enzyme deficiency-related hemolytic anemia may present as neonatal jaundice or become manifest due to exposure to infections, favism and medications later in life. Dapsone is a medication that is preferred by doctors in the treatment of many dermatological disorders such as pemphigus vulgaris, and leads to hemolysis in the presence of G6PD enzyme deficiency. In this type of non-immune hemolysis, haptoglobulin is low and Coombs' tests are negative. Hemolytic anemia, a serious complication that may appear subsequent to dapsone use, can be prevented by testing G6PD enzyme levels prior to dapsone therapy. In this case, we emphasized that the hemolytic anemia in the patient using dapsone may be due to G6PD enzyme deficiency.