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Year : 2018  |  Volume : 7  |  Issue : 2  |  Page : 64-68

Relationship of clinical deterioration in leprosy patients while on multidrug therapy with their glucose-6-phosphate dehydrogenase levels

1 Department of Dermatology, Venereology and Leprology, TMMC and RC, Moradabad, Uttar Pradesh, India
2 Department of Medicine, Sundaram Foundation, Chennai, Tamil Nadu, India
3 Department of Medicine, TMMC and RC, Moradabad, Uttar Pradesh, India

Correspondence Address:
Abhishek Sharma
Department of Dermatology, Venereology and Leprology, TMMC and RC, Moradabad, Uttar Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JCSR.JCSR_36_18

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Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is known to cause haemolysis in patients with Hansen's disease receiving dapsone containing multidrug-therapy (MDT). However, sparse recent data are available on this topic from India. Methods: All patients aged over 10 years with Hansen's disease receiving MDT who presented with clinical deterioration to our tertiary care teaching hospital in Moradabad, Uttar Pradesh, India, were included in the study. G6PD levels were estimated in all of them. Once G6PD deficiency was confirmed dapsone was stopped and rescue therapy was initiated. Results: Between March 2015 and June 2016, 50 patients (mean age 34 ± 13.3 years) were included. G6PD deficiency was found in 14.3% patients. Peripheral blood smear showed Heinz bodies and bite cells in all of them. Mean pretreatment G6PD levels were 19.5 (range 17.5 – 25) units/g haemoglobin, mean serum bilirubin was 3.3 (range 1.6-9.2) mg/dL. Nineteen patients had lepra reactions (type 1 = 5 type 2 = 14). Ten patients required packed red blood cell transfusion. Conclusions: Our observations suggest that checking for G6PD levels before initiating dapsone containing MDT can be helpful in reducing the occurrence of haemolytic complications.

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