Waldinger T P, Siegle R J, Weber W, Voorhees J J
Arch Dermatol. 1984 Mar;120(3):356-9.
A severe motor and a minor sensory neuropathy developed in a man being treated with dapsone (4,4'-diaminodiphenylsulfone) for dermatitis herpetiformis. He had received dapsone for 16 years before any signs of neurotoxicity became evident. Electrodiagnostic and clinical features were consistent with an axonal neuropathy. Clinical characteristics of dapsone-induced neuropathy include a motor neuropathy affecting the extremities, usual onset within five years after the initiation of dapsone therapy, dapsone dosage usually equal to or greater than 300 mg/day, and, almost always, complete recovery from the neuropathy after dapsone-dose reduction or withdrawal. The patient was found to be a slow acetylator of sulfamethazine, and therefore is a slow acetylator of dapsone. An HLA typing was done on the patient. New cases of dapsone-induced neuropathy should be HLA typed and have acetylation profiles in an attempt to identify future high-risk patients. This case is noteworthy for the length of time of dapsone usage (16 years) and the low daily dosage of dapsone (100 mg) taken prior to the development of neuropathy.
一名患有疱疹样皮炎的男性在接受氨苯砜（4,4'-二氨基二苯砜）治疗时出现了严重的运动性和轻度感觉性神经病变。在任何神经毒性迹象出现之前，他已经服用氨苯砜16年了。电诊断和临床特征与轴索性神经病变一致。氨苯砜诱发神经病变的临床特征包括影响四肢的运动性神经病变，通常在氨苯砜治疗开始后五年内发病，氨苯砜剂量通常等于或大于300毫克/天，并且几乎总是在减少氨苯砜剂量或停药后神经病变完全恢复。该患者被发现是磺胺二甲嘧啶的慢乙酰化者，因此也是氨苯砜的慢乙酰化者。对该患者进行了HLA分型。新的氨苯砜诱发神经病变病例应进行HLA分型并检测乙酰化谱，以试图识别未来的高危患者。该病例值得注意的是氨苯砜使用时间长（16年）以及在神经病变发生前氨苯砜的每日剂量低（100毫克）。
