Abstract
A 73-year-old man was admitted in respiratory failure that had subacutely progressed after five weeks of dapsone treatment for a skin rash. He also presented with fever, systemic erythroderma and liver dysfunction. Chest computed tomography showed diffuse reticular shadows with ground-glass opacity and bilateral mediastinal lymphadenopathy. Lymphocytes, but not eosinophils, were increased in the bronchoalveolar lavage fluid. Moreover, reactivation of human herpes virus-6 was confirmed on a paired serum test. Finally, we diagnosed the patient with dapsone hypersensitivity syndrome (DHS), a rare adverse event of this drug. Lung injury unaccompanied by eosinophilia in the bronchoalveolar lavage fluid is even more rare as a DHS-related lung manifestation.
MeSH terms
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Acute Lung Injury / chemically induced
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Aged
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Anti-Infective Agents / adverse effects*
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Bronchoalveolar Lavage Fluid / cytology
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Dapsone / adverse effects*
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Diagnosis, Differential
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Drug Hypersensitivity Syndrome / diagnosis
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Drug Hypersensitivity Syndrome / etiology*
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Eosinophilia / diagnosis
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Eosinophils / physiology
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Fever / chemically induced
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Humans
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Immune Reconstitution Inflammatory Syndrome / chemically induced
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Leukocyte Count
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Lymphatic Diseases / chemically induced
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Lymphocytes / physiology
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Lymphocytosis / chemically induced
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Male
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Mediastinal Diseases / chemically induced
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Pruritus / drug therapy
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Respiratory Insufficiency / chemically induced*
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Roseolovirus Infections / chemically induced
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Tomography, X-Ray Computed
Substances
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Anti-Infective Agents
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Dapsone