Treatment of refractory iga vasculitis with dapsone: A systematic review

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

Research output: Contribution to journalReview article

1 Citation (Scopus)

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 retriev-ed 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.

Original languageEnglish
Pages (from-to)158-163
Number of pages6
JournalKorean Journal of Pediatrics
Volume63
Issue number5
DOIs
Publication statusPublished - 2020 May

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Pediatrics

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    Lee, K. H., Hong, S. H., Jun, J., Jo, Y., Jo, W., Choi, D., Joo, J., Jung, G., Ahn, S., Kronbichler, A., Eisenhut, M., & Shin, J. I. (2020). Treatment of refractory iga vasculitis with dapsone: A systematic review. Korean Journal of Pediatrics, 63(5), 158-163. https://doi.org/10.3345/kjp.2019.00514