To the Editor.—
Although our recent review of the literature found no evidence of fatalities from agranulocytosis in patients on sulfones,1 a paper has since appeared that the readership should be aware of. Sixteen cases of agranulocytosis were recently reported in patients in Vietnam receiving sulfones for malaria prophylaxis.2 Eight of the 16 patients died of sepsis while granulocytopenic, a 50% mortality!The exact dosage of the drug was variable because of battlefield conditions and, thus, no definite dose relationship can be made. Duration of therapy varied from three weeks to three months. In those that recovered the "pseudoleukemia" picture previously noted was often seen. Equally significant was that one patient (whose white blood cell count fell to 2,800/cu mm with 18% band forms, returning to normal in five days) was inadvertently given an additional course of dapsone (25 mg daily for 14 days) without hematologic effect. This
Millikan LE. DRUG REACTIONS TO THE SULFONES. Arch Dermatol. 1971;103(3):343. doi:10.1001/archderm.1971.04000150113026
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