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Heparin-Induced Thrombocytopenia Presenting as Bilateral Adrenal Hemorrhages
Open accessAbstract
Drug Administration in 2005 as a topical 5% gel (50 mg of dapsone per 1 g of product; Aczone, Allergan).After the topical application of dapsone gel, a plasma level is detectable within 2 hours and has a half-life of 48 hours. 2 Our patient had been applying a pea-sized amount of topical dapsone twice daily for 7 days before presentation.Details of the mechanism of dapsone-induced methemoglobinemia and a discussion of other possible contributing factors in this patient's case are provided in the Supplementary Appendix, available with the full text of this letter at NEJM.org.Our case report highlights the potential for systemic absorption with clinical methemoglobinemia after prescribed therapeutic use of a topical dapsone-containing product.
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“heparin (thrombocytopenia-mediated adrenal hemorrhage) (48).”
From The Changing Face of Drug-induced Adrenal Insufficiency in the Food and Drug Administration Adverse Event Reporting System (2022) · cites this paper as [48]
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Metadata
- Authors
- Warkentin, T. E., Safyan, E. L., & Linkins, L.-A.
- Affiliations
- McMaster University (CA)
- University of Pittsburgh Medical Center (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2015-01-29
- Volume
- 372
- Issue
- 5
- Pages
- 492-494
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2020248408
- Cited by
- 57
- References
- 4
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 1 · 2023: 5 · 2022: 4 · 2021: 7 · 2020: 7 · 2019: 4 · 2018: 6 · 2017: 5 · 2016: 5 · 2015: 6
- FWCI
- 7.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hematology › Heparin-Induced Thrombocytopenia and Thrombosis
- Health Sciences › Medicine › Hematology › Methemoglobinemia and Tumor Lysis Syndrome
- Health Sciences › Medicine › Hematology › Platelet Disorders and Treatments
- Keywords
- heparin-induced thrombocytopenia, bilateral adrenal hemorrhage, dapsone, methemoglobinemia, systemic absorption, adverse drug reactions
- MeSH terms
- Adrenal Gland Diseases, Anticoagulants, Hemorrhage, Heparin, Humans, Thrombocytopenia
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