YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. ==VASCULITIS, PURPURA AND HENOCH-SCHOENLEIN== 1 AUTHOR Valero Prieto I AUTHOR Calvo Catala J AUTHOR Hortelano Martinez E AUTHOR Abril L de Medrano V AUTHOR Glez-Cruz Cervellera MI AUTHOR Herrera Ballester A AUTHOR Orti E TITLE [Schoenlein-Henoch purpura associated with spiramycin and with important digestive manifestations] SOURCE Rev Esp Enferm Dig; VOL 85, ISS 1, 1994, P47-9 ABSTRACT Schonlein-Henoch purpura is a vasculitis due to hypersensitivity characteristic of the infancy that affects preferably small vessels. The etiology is unknown, although it has been related to allergic reactions to drugs, infections, vaccines and insecta bites. An adult with a Schonlein-Henoch purpura after receiving spiramicin is presented, beginning with epigastric pain and vomiting and the purpura appearing subsequently. 4 AUTHOR Duell PB AUTHOR Morton WE TITLE Henoch-Schonlein Purpura Following Thiram Exposure SOURCE Archives of Internal Medicine, Vol. 147, No. 4, pages 778-779, 15 references, 19871987 ABSTRACT A case report of Henoch-Schonlein purpura in a tree planter following exposure to tetramethylthiuram-disulfide (137268) (thiram) was presented. A 23 year old Mexican man presented to the hospital with a 10 to 12 day history of abdominal pain, generalized arthralgias, and a progressive purpuric rash. The patient and several of his coworkers had suffered eye, skin and upper respiratory tract irritation, cough and nausea during the preceding month, associated with planting tree seedlings treated with a 42 percent thiram solution. The patient subsequently developed fever, malaise, severe nausea and vomiting, hematemesis, and melena. Leukocytoclastic vasculitis was observed in a skin biopsy, and gastroduodenoscopy revealed a small Mallory Weiss tear and diffuse vasculitic erosions in the duodenum. The patient received a trial of corticosteroid therapy and was discharged significantly improved after 14 days. The authors conclude that occupational exposure to thiram probably induced Henoch Schonlein purpura in this patient, and that increased awareness of the possibility of this phenomenon may result in recognition of additional cases of thiram induced Henoch Schonlein purpura. 8 AUTHOR Ledermann JA AUTHOR Hoffbrand BI TITLE Dapsone in allergic vasculitis: its use in Henoch-Schoenlein disease following vaccination SOURCE J. R. Soc. Med.; VOL 76 ISS Jul 1983, P613-614, (REF 17) ABSTRACT IPA COPYRIGHT: ASHP The use of dapsone (I) to treat purpura with necrotic lesions which developed in a 33-yr-old man after cholera and typhoid A and B, and yellow fever vaccination is reported. The vasculitic skin lesions were sensitive to I, disappearing after 2 days treatment with 50 mg twice daily, and relapsing within 48 h of stopping the drug. The patient was maintained on 75 mg of I daily. 17 AUTHOR Frey HM AUTHOR Gershon AA AUTHOR Borkowsky W AUTHOR Bullock WE TITLE Fatal reaction to dapsone during treatment of leprosy. SOURCE Ann Intern Med; VOL 94, ISS 6, 1981, P777-9 ABSTRACT A Burmese boy being treated with dapsone (diaminodiphenylsulfone [DDS]), 100 mg daily, for lepromatous leprosy had a fatal reaction to the drug 3 weeks after therapy was started. The clinical symptoms and progression of illness conform well to a "DDS syndrome" first described in the early 1950s. Although the syndrome clinically resembles infectious mononucleosis, neither Epstein-Barr virus nor cytomegalovirus was implicated as an etiologic agent in this case. The syndrome has been recognized during initiation of dapsone therapy for lepromatous leprosy and has led to the use of a prolonged induction period with initial dosages as low as 25 mg/week. However, because dapsone resistance has been recognized in some strains of Mycobacterium leprae, slow induction of therapy has been replaced with the schedule used for this patient. This report of a fatal reaction to dapsone emphasizes the need for caution when initiating therapy with the drug at full dosage.