Abstract
A importância mundial da farmacovigilância vem aumentando, mesmo nos países subdesenvolvidos. Neste contexto, a síndrome de hipersensibilidade à dapsona (SHD), um efeito colateral raro e potencialmente grave, deve ser considerada, sem, entretanto, comprometer a segurança da droga e sua ampla utilização. Objetivando padronizar os critérios diagnósticos da síndrome, realizou-se uma revisão sistemática da literatura analisando trabalhos publicados de quinze países endêmicos entre 1956 e 2001. Cento e oito casos foram reportados neste período, destes 96,2% após 1980, com 13,3% de óbitos. Neste grupo, 59% apresentaram a síndrome completa – febre, rash, linfadenomegalia e hepatite, enquanto 41% expressaram forma incompleta. A taxa de mortalidade do grupo que preenche os critérios de SHD completa foi de 9,6% e não houve associação estatística com injúria hepática. Todavia ressalta-se a pouca qualidade dos dados coletados, o que reforça a necessidade de relatos mais precisos em futuras publicações.
References
2 AHMADI, M.A. Dapsone blood dyscrasia in the mouse: evidence for the role of an active metabolite. J. Pharmacol. Pharmacokinetic, v.48, n.2, p.228-232, 1996.
3 ALDDAY, E.J.; BARNES J. Toxic effects of diaminodiphenylsulphone in leprosy. Lancet, ii, p.205-206, 1951.
4 ANDRADE, Z.M.V.; FRANÇA, E.R.; TEIXEIRA, M.A.G.; SANTOS, I.B.S. Síndrome sulfônica: relato de um caso. An. bras. Dermatol., v.74, n.1, p. 59-61, 1999.
5 ARUNTHATHI, S.; JACOB, M.; THERASA, A. The dapsone syndrome. Indian J. Leprosy, v.56, p.206, 1984.
6 BARBOSA, A.M.; MARTINS, E.J.; FLEURY, R.N.; OPROMOLLA, D.V.A. One more case of sulfone syndrome. Hansen. Int., v.25, n.2, p.159-162, 2000.
7 BLETTNER, M.; SAUERBREI, W.; SCHLEHOFER, B.; SCHEUCHENPFLUG, T.; FRIEDENREICH, C. Traditional reviews, meta-analyses and pooled analyses in epidemiology. Int. J. Epidemiol., v.28, p.1-9, 1999.
8 BLULUHM, R.E. Development of dapsone toxicity in patient with inflammatory dermatoses: Activity of acetylation and hydroxylation of dapsone as risk factors. Clin. Pharmacol. Ther., v.65, n.6, p.598-603, 1999.
9 CABRERA, H.N; VALENTE, E.; GALLEGOS, M.C.; GARCIA, S.M. Síndrome de hipersensibilidad a la dapsona. Arch. argent. Dermat., v.47, n.6, p.255-258, 1997.
10 CHAN, H.; LEE, K. Tonsillar membrane in the DDS(dapsone) syndrome. Int. J. Dermatol., v.30, n.3, p.216-217, 1991.
11 FREY, H.M.; GERSHON, A.A.; BORKOWSKY, W.; BULLOCK, W.E. Fatal reaction to dapsone during treatment of leprosy. Ann. Intern.
Med., v.94, p.777-779, 1981.
12 GALLO, M.E.N.; NERY, J.A.C.; GARCIA, C.C. Intercorrências pelas drogas utilizadas nos esquemas poliquimioterápicos em hanseníase. Hansen. Int., v.20, n.2, p.46-50, 1995.
13 GOKHALE, N.R.; SULE, R.R.; GHARPURE, M.B. Dapsone syndrome. Ind. J. Dermatol. Venereol. Leprol., v.58, p.376-378, 1992.
14 GUPTA, C.M.; BHATE, R.D.; SINGH, I.P. The dapsone syndrome - a case report. Indian J. Leprosy, v.57, p.193-195, 1985.
15 JAMROZIK, K. Dapsone syndrome occurring in two brothers. Leprosy Rev., v.57, p.57-62, 1986.
16 JOHNSON, D.A.; CATTAU, E.L.; KURITSKY, J.N.; ZIMMERMAN, H.J. Liver involvement in the sulfone syndrome. Arch. Intern. Med.,
v.145, p.875-877, 1986.
17 JOSEPH, M.S. Hypersensitivity reaction to dapsone. Four case reports. Leprosy Rev., v.56, p.315-320, 1985.
18 KHARE, A.K.; BANSAL, N.K.; MEENA, H.S. Dapsone syndrome - a case report. Indian J. Leprosy, v.59, n.1, p.106109, 1987.
19 KROMANN, N.P.; VIHELMSEN, R.; STAHL D. The dapsone syndrome. Arch. Dermatol., v.118, p.531-532, 1982.20 KUMAR, R.H.; KUMAR, M.V.; THAPPA, D.M. Dapsone syndrome – a five-year retrospective analysis. Indian J. Leprosy, v.70, n.3, p.271-276, 1998.
21 LEIKER, D.L. The mononucleosis syndrome in leprosy patients treated with sulfone. Int. J. Leprosy, v.24, p.402-405, 1956.
22 LOWE, J. Treatment of leprosy with diamino diphenylsulphone. Lancet, p.145-150, 1950.
23 MILLIAM, M. Role of lipid Peroxidation in dapsone -induced Hemolytic Anemia. J. Pharm. Exp. Ther., v.287, p.868-876, 1988.
24 MOHAMED, K.N. Hypersensitivity reaction to dapsone: report from Malaysia. Leprosy Rev., v.55, p.385-389, 1984.
25 NARASIMHA, P.; LAKSHMI, T.S.S. Increase in incidence of dapsone hypersensitivity syndrome – an appraisal. Leprosy Rev., v.72, p. 57-62, 2001.
26 OPROMOLLA, V.A.; FLEURY, R.N. Síndrome da sulfona e reação reversa. Hansen. Int., v.19, n.2, p.70-76, 1994.
27 POTTER, B.; SYZYMANSKI, F.J.; FRETZIN, D. Erythema elevatum diutinum and sulfone hypersensitivity. Arch. Dermatol., v.95, p.436-440, 1967.
28 PAVITHRAN, K. Dapsone syndrome with polyarthritis: a case report. Indian J. Leprosy, v.62, n.2, p.230-232, 1990.
29 PERISSÉ, A.R.S.; GOMES, M.M.; NOGEIRA, S.A. Revisões sistemáticas (inclusive metanálises) e diretrizes clínicas. In: GOMES, M.M. Medicina baseada em evidencias. Damus, p.131-148, 2001.
30 PRUSSICK, R.; SHEAR, N.H. Dapsone hypersensitivity syndrome. J. Amer. Acad. Dermatol., v.35, n.2, p.346-349, 1996.
31 QUEIROZ, R.H. Influence of acetylator phenotype on the haematologycal and biochemical effects associated with dapsone in
leprosy patients. Leprosy Rev., v.68, n.3, p.21-217, 1997.
32 RAMANAN, C.; GHORPADE; MANGLANI, P.R. Dapsone syndrome. Indian J. Leprosy, v.63, n.2, p.226-228, 1991.
33 REEVE, P.A., ALA, J. HALL, J.J. Dapsone syndrome in Vanuatu: a high incidence during multidrug treatment (MDT) of leprosy. J. Trop. Med. Hyg., v.95, n.4, p.266-270, 1992.
34 REGE, V.L.; SHUKLA, P.; MASCARENHAS, M.F. Dapsone syndrome in Goa. Indian J. Leprosy, v.66, n.1, p.59-64, 1994. 84 Hansenologia Internationalis
35 RICHARDUS, J.H.; SMITH, T.C. Increased incidence in leprosy of hypersensitivity reactions to dapsone after introduction of multidrug therapy. Leprosy Rev., v.60, p.267-273, 1989.
36 ROSE, P. Adverse reactions to rifampicin and dapsone. Leprosy Rev., v.56, p.171, 1985.
37 SANTOS, M.E.; LETA, G.C.; OLIVEIRA, M.L.W.; GOMES, M.K.; MACEIRA, J. Dapsone hypersensitivity syndrome(DHS): not so rare
to be minimezed in endemic countries. In: INTERNATIONAL LEPROSY CONGRESS, 16, Brazil, 4-9, August, 2002
38 SARDARI, L., GARG, B.R. Sulfone induced exfoliative dermatitis and hepatitis. Leprosy in India, v.52, n.2, p.302-305, 1980.
39 SHARMA, V.K.; KAUR, S.; KUMAR, B.; SINGH, M. Dapsone syndrome in India. Indian J. Leprosy, v.57, p.8, 1985.
40 SMITH, W.C.S. Hypersensitivity reaction to dapsone. Leprosy Rev., v.57, p.179-180, 1986.
41 SMITH, D.A. Speculation on the substrate-structure-activity relationship (SSR) of cytochrome P450 enzimes. Biochem. Pharmacol., v.44, p.2089-2098, 1992.
42 SMITH, W.C.S. Are hypersensitivity reactions to dapsone becoming more frequent? Leprosy Rev., v.59, p.53-58, 1988.
43 TOMECKI, K. J.; CATALANO C. J. Dapsone hypersensitivity: the sulfone sydrome revisited. Arch Dermatol,. v.117, n.1, p.38-39, 1981.
44 TROUB, B.V.W.; STUN, R.S. Cutaneous drug reactions. In: FAUCI, A.S. Harrison’s principles of internal medicine. 14ed. McGraw-Hill, 1998. p.304-310
45 WILLE, C.R.; MORROW, J.D. Case report: dapsone hypersensitivity syndrome associated with treatment of the bite of a brown recluse spider. Am. J. Med. Sci., v.296, n.4, p.270-271, 1988.
46 WOZELL, G. Hypersensitivity to dapsone - an epidemiomological review. In: INTERNATIONAL LEPROSY CONGRESS, 15, Beijing
1998. Abstracts.
47 Homepage institucional da biblioteca de Cochrane - ano 2000. Disponível em: http://www.cochranelibrary.com acesso em
30/07/2002
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