Skip to main content
PMC home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1980 Oct;64(10):741–744. doi: 10.1136/bjo.64.10.741

Permanent retinal damage following massive dapsone overdose.

D J Kenner, K Holt, R Agnello, G H Chester
PMCID: PMC1043808  PMID: 7426547

Abstract

A massive dose of 7.5 g of 4,4'-diamino, diphenyl sulphone (dapsone) taken as a suicide attempt in a patient on long-term therapy for tuberculoid leprosy resulted in permanent bilateral retinal necrosis, previously unreported side effect of this drug. The patient developed a severe haemolytic anaemia, methaemoglobinaemia, and acute renal failure requiring peritoneal dialysis. It is proposed that the retinal damage was due to a combination of severe hypoxaemia and the physical effects of red cell fragmentation producing vascular occlusion in the macular and perimacular region, with consequent ischaemic necrosis.

Full text

PDF
741

Images in this article

742Image
on p.742
743Image
on p.743

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Acacio I., Goldberg M. F. Peripapillary and macular vessel occlusions in sickle cell anemia. Am J Ophthalmol. 1973 May;75(5):861–866. doi: 10.1016/0002-9394(73)90892-1. [DOI] [PubMed] [Google Scholar]
  2. Asdourian G. K., Nagpal K. C., Busse B., Goldbaum M., Patriankos D., Rabb M. F., Goldberg M. F. Macular and perimacular vascular remodelling sickling haemoglobinopathies. Br J Ophthalmol. 1976 Jun;60(6):431–453. doi: 10.1136/bjo.60.6.431. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bird A. C., Weale R. A. On the retinal vasculature of the human fovea. Exp Eye Res. 1974 Nov;19(5):409–417. doi: 10.1016/0014-4835(74)90050-5. [DOI] [PubMed] [Google Scholar]
  4. Bresnick G. H., De Venecia G., Myers F. L., Harris J. A., Davis M. D. Retinal ischemia in diabetic retinopathy. Arch Ophthalmol. 1975 Dec;93(12):1300–1310. doi: 10.1001/archopht.1975.01010020934002. [DOI] [PubMed] [Google Scholar]
  5. Cooke T. J. Dapsone poisoning. Med J Aust. 1970 Jun 6;1(23):1158–1159. doi: 10.5694/j.1326-5377.1970.tb84486.x. [DOI] [PubMed] [Google Scholar]
  6. Cream J. J., Scott G. L. Anaemia in dermatitis herpetiformis. The role of dapsone-induced haemolysis and malabsorption. Br J Dermatol. 1970 Apr;82(4):333–342. doi: 10.1111/j.1365-2133.1970.tb06829.x. [DOI] [PubMed] [Google Scholar]
  7. DAVIES R. Fatal poisoning with udolac (diaminodiphenylsulphone). Lancet. 1950 May 13;1(6611):905–906. doi: 10.1016/s0140-6736(50)90736-7. [DOI] [PubMed] [Google Scholar]
  8. Degowin R. L., Eppes R. B., Powell R. D., Carson P. E. The haemolytic effects of diaphenylsulfone (DDS) in normal subjects and in those with glucose-6-phosphate-dehydrogenase deficiency. Bull World Health Organ. 1966;35(2):165–179. [PMC free article] [PubMed] [Google Scholar]
  9. Goldberg M. F. Classification and pathogenesis of proliferative sickle retinopathy. Am J Ophthalmol. 1971 Mar;71(3):649–665. doi: 10.1016/0002-9394(71)90429-6. [DOI] [PubMed] [Google Scholar]
  10. HARRIS J. W., BREWSTER H. H., HAM T. H., CASTLE W. B. Studies on the destruction of red blood cells. X. The biophysics and biology of sickle-cell disease. AMA Arch Intern Med. 1956 Feb;97(2):145–168. doi: 10.1001/archinte.1956.00250200021002. [DOI] [PubMed] [Google Scholar]
  11. Hjelm M., de Verdier C. H. Biochemical effects of aromatic amines. I. Methaemoglobinaemia, haemolysis and Heinz-body formation induced by 4,4'-diaminodiphenylsulphone. Biochem Pharmacol. 1965 Jul;14(7):1119–1128. doi: 10.1016/0006-2952(65)90041-9. [DOI] [PubMed] [Google Scholar]
  12. Knapp J. W. Isolated macular infarction in sickle cell (SS) disease. Am J Ophthalmol. 1972 Jun;73(6):857–859. doi: 10.1016/0002-9394(72)90452-7. [DOI] [PubMed] [Google Scholar]
  13. Kohner E. M., Dollery C. T., Paterson J. W., Oakley N. W. Arterial fluorescein studies in diabetic retinopathy. Diabetes. 1967 Jan;16(1):1–10. doi: 10.2337/diab.16.1.1. [DOI] [PubMed] [Google Scholar]
  14. MOSER K. M., SHEA J. G. The relationship between pulmonary infarction, cor pulmonale and the sickle states. Am J Med. 1957 Apr;22(4):561–579. doi: 10.1016/0002-9343(57)90110-9. [DOI] [PubMed] [Google Scholar]
  15. McKenna W. B., Chalmers A. C. Agranulocytosis Following Dapsone Therapy. Br Med J. 1958 Feb 8;1(5066):324–325. doi: 10.1136/bmj.1.5066.324. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Rasbridge M. R., Scott G. L. The haemolytic action of dapsone: changes in the red-cell membrane. Br J Haematol. 1973 Feb;24(2):183–193. doi: 10.1111/j.1365-2141.1973.tb05738.x. [DOI] [PubMed] [Google Scholar]
  17. Rasbridge M. R., Scott G. L. The haemolytic action of dapsone: the effect on red-cell glycolysis. Br J Haematol. 1973 Feb;24(2):169–181. doi: 10.1111/j.1365-2141.1973.tb05737.x. [DOI] [PubMed] [Google Scholar]
  18. Ryan S. J., Jr Occlusion of the macular capillaries in sickle cell hemoglobin C disease. Am J Ophthalmol. 1974 Apr;77(4):459–461. doi: 10.1016/0002-9394(74)90454-1. [DOI] [PubMed] [Google Scholar]
  19. STANFIELD J. P. A CASE OF ACUTE POISONING WITH DAPSONE. J Trop Med Hyg. 1963 Nov;66:292–295. [PubMed] [Google Scholar]
  20. Welch R. B., Goldberg M. F. Sickle-cell hemoglobin and its relation to fundus abnormality. Arch Ophthalmol. 1966 Mar;75(3):353–362. doi: 10.1001/archopht.1966.00970050355008. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES