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Treatment of refractory IgA vasculitis with dapsone: a systematic review

Authors
 Keum Hwa Lee  ;  Sung Hwi Hong  ;  Jinhae Jun  ;  Youngheun Jo  ;  Woogyeong Jo  ;  Dayeon Choi  ;  Jeongho Joo  ;  Guhyun Jung  ;  Sunghee Ahn  ;  Andreas Kronbichler  ;  Michael Eisenhut  ;  Jae Il Shin 
Citation
 Clinical and Experimental Pediatrics, Vol.63(5) : 158-163, 2020-05 
Journal Title
 Clinical and Experimental Pediatrics 
Issue Date
2020-05
Keywords
Dapsone ; Henoch-Schonlein purpura ; IgA vasculitis ; Systematic review
Abstract
IgA vasculitis, formerly known as Henoch-Schönlein purpura, is a systemic IgA-mediated vasculitis of the small vessels commonly seen in children. The natural history of IgA vasculitis is generally self-limiting; however, one-third of patients experience symptom recurrence and a refractory course. This systematic review examined the use of dapsone in refractory IgA vasculitis cases. A literature search of PubMed databases retrieved 13 articles published until June 14, 2018. The most common clinical feature was a palpable rash (100% of patients), followed by joint pain (69.2%). Treatment response within 1-2 days was observed in 6 of 26 patients (23.1%) versus within 3-7 days in 17 patients (65.4%). Relapse after treatment discontinuation was reported in 17 patients (65.4%) but not in 3 patients (11.5 %). Four of the 26 patients (15.4%) reported adverse effects of dapsone including arthralgia (7.7%), rash (7.7%), and dapsone hypersensitivity syndrome (3.8%). Our findings suggest that dapsone may affect refractory IgA vasculitis. Multicenter randomized placebo-controlled trials are necessary to determine the standard dosage of dapsone at initial or tapering of treatment in IgA vasculitis patients and evaluate whether dapsone has a significant benefit versus steroids or other medications.
Files in This Item:
T202002814.pdf Download
DOI
10.3345/kjp.2019.00514
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Shin, Jae Il(신재일) ORCID logo https://orcid.org/0000-0003-2326-1820
Lee, Keum Hwa(이금화) ORCID logo https://orcid.org/0000-0002-1511-9587
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/179209
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