{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:10:01Z","timestamp":1756275001100,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,12,5]]},"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2019-232217","type":"journal-article","created":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T04:55:13Z","timestamp":1576817713000},"page":"e232217","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Is dapsone still relevant in immune thrombocytopenia in resource limited settings?"],"prefix":"10.1136","volume":"12","author":[{"given":"Preeti","family":"Dalal","sequence":"first","affiliation":[{"name":"Department of General Medicine, Government Medical College and Hospital, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manisha","family":"Gulia","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Government Medical College and Hospital, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3992-1013","authenticated-orcid":false,"given":"Monica","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Government Medical College and Hospital, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Tahlan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Government Medical College and Hospital, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,12,19]]},"reference":[{"key":"2025082622493581000_12.12.e232217.1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-08-302984"},{"key":"2025082622493581000_12.12.e232217.2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23272"},{"key":"2025082622493581000_12.12.e232217.3","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-03-632000"},{"key":"2025082622493581000_12.12.e232217.4","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1002\/ajh.2830440117","article-title":"Dapsone for autoimmune thrombocytopenic purpura","volume":"44","author":"Godeau","year":"1993","journal-title":"Am J Hematol"},{"key":"2025082622493581000_12.12.e232217.5","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1002\/ajh.2830460423","article-title":"Dapsone for idiopathic thrombocytopenic purpura","volume":"46","author":"Linares","year":"1994","journal-title":"Am J Hematol"},{"key":"2025082622493581000_12.12.e232217.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2005.00545.x"},{"key":"2025082622493581000_12.12.e232217.7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0187296","article-title":"Efficacy and safety of dapsone as second line therapy for adult immune thrombocytopenia: a retrospective study of 42 patients","volume":"12","author":"Est\u00e8ve","year":"2017","journal-title":"PLoS One"},{"key":"2025082622493581000_12.12.e232217.8","doi-asserted-by":"crossref","first-page":"e489","DOI":"10.1016\/S2352-3026(16)30109-0","article-title":"High-dose dexamethasone compared with prednisone for previously untreated primary immune thrombocytopenia: a systematic review and meta-analysis","volume":"3","author":"Mithoowani","year":"2016","journal-title":"Lancet Haematol"},{"key":"2025082622493581000_12.12.e232217.9","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1080\/09537100802315110","article-title":"Efficacy and safety of dapsone as a second-line treatment in non-splenectomized adults with immune thrombocytopenic purpura","volume":"19","author":"Vancine-Califani","year":"2008","journal-title":"Platelets"},{"key":"2025082622493581000_12.12.e232217.10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1990.tb02569.x"},{"key":"2025082622493581000_12.12.e232217.11","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0609.2003.00076.x"},{"key":"2025082622493581000_12.12.e232217.12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1994.tb04810.x"},{"key":"2025082622493581000_12.12.e232217.13","doi-asserted-by":"crossref","first-page":"39","DOI":"10.5152\/eurjrheumatol.2014.14065","article-title":"Methorexate therapy in a patient with rheumatoid arthritis complicated by idiopathic thrombocytopenic purpura","volume":"2","author":"Komo\u011flu","year":"2015","journal-title":"Eur J Rheumatol"},{"key":"2025082622493581000_12.12.e232217.14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1995.tb05179.x"},{"key":"2025082622493581000_12.12.e232217.15","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1997.412687.x"},{"key":"2025082622493581000_12.12.e232217.16","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1002\/ajh.22266","article-title":"Dapsone salvage therapy for adult patients with immune thrombocytopenia relapsed or refractory to steroid and rituximab","volume":"87","author":"Zaja","year":"2012","journal-title":"Am J Hematol"},{"key":"2025082622493581000_12.12.e232217.17","doi-asserted-by":"publisher","DOI":"10.3109\/09537104.2014.886677"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-232217","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T05:49:43Z","timestamp":1756273783000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-232217"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12]]},"references-count":17,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2019,12,19]]},"published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1136\/bcr-2019-232217"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-232217","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,12]]}}}