Dapsone treatment in a girl with severe chronic thrombocytopenic purpura. Does it work? Do not touch it!

Dapsone has been shown to be effective in treating immune thrombocytopenic purpura (ITP) in adults. In children the experience is limited. We describe our experience using dapsone in a female with refractory, symptomatic ITP who suffered intracranic haemorrhage and massive gastric bleeding. After treatment platelet counts was more than 100 x 103/µL, and reached 1000x103/µL. Discontinuation resulted in a rapid decrease in platelet counts, with severe intracranial haemorrhage (ICH). The recovery of dapsone led the platelets count to lower values. We suggest that treatment should not be discontinued in responders, at least in children with symptomatic ITP. Additional studies of dapsone in children are warranted.