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Case report
Is dapsone still relevant in immune thrombocytopenia in resource limited settings?
  1. Preeti Dalal1,
  2. Manisha Gulia1,
  3. Monica Gupta1 and
  4. Anita Tahlan2
  1. 1Department of General Medicine, Government Medical College and Hospital, Chandigarh, India
  2. 2Department of Pathology, Government Medical College and Hospital, Chandigarh, India
  1. Correspondence to Monica Gupta; monicamanish2001{at}


Immune thrombocytopenia is an autoimmune disorder characterised by autoantibody production against platelets, increased platelet destruction and impaired thrombopoiesis. Steroids are the first-line agents whenever treatment is indicated; however, some patients may not respond and the responders may as well relapse while the dose is being tapered. Side effects of steroids prohibits their long-term use and patients often have to be switched to other agents. Standard drug management with intravenous immunoglobulins and thrombopoietin receptor analogues is difficult to administer in patients from low socioeconomic regions of the world making the management even more challenging. Hence, after reviewing the literature and considering the cost in comparison to all the second-line agents available, we tried dapsone in a steroid-dependent patient of immune thrombocytopenic purpura who had developed major steroid-related side effects. Patient showed good response to dapsone and has been in remission for around one and a half years.

  • haematology (drugs and medicines)
  • haematology (incl blood transfusion)
  • therapeutic indications
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  • Contributors All the authors have provided substantial contributions in the clinical management of the case and literature review on the topic in question. PD and MGul have drafted the manuscript and AT and MGup have revised it critically for important intellectual content. All the authors have read the final version and approved it. All the authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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