To the Editor.—
Dapsone (4,4′-diaminodiphenylsulfone) causes dose-limiting hemolysis and methemoglobinemia, with formation of Heinz bodies (denatured hemoglobin particles) and characteristic poikilocytes.1 It has been proposed that Heinz body testing during dapsone treatment might be useful2; we have found it to be of restricted value.Twelve clinically stable, nonsplenectomized patients with normal erythrocyte glucose-6-phosphate dehydrogenase levels3 had been treated with constant dosage of dapsone for various skin disorders for at least one month. Mean (±SD) daily drug dosage was 122 (±69) mg. Complete blood cell counts, methemoglobin levels,4 reticulocyte counts,5 and Heinz body quantifications6 were performed two to four times (mean interval [±SD], 6.9 ± 5.7 weeks, minimum interval, one week, 35 studies).Normal values used for hemoglobin levels, reticulocyte count, methemoglobin levels, and Heinz body counts are 13 to 17 g/dL, 25,000 to 75,000/cu mm, less than 1.0%, and none detected, respectively. Respective mean
Rosove MH, Harwig SSL, Ahmed RA. Dapsone and Heinz Bodies. Arch Dermatol. 1985;121(1):25. doi:10.1001/archderm.1985.01660010029009
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