Mohammad
This has been shown before with dapsone (Decreased HbA1c levels due to
sulfonamide-induced hemolysis in two IDDM patients. Tack CJ, Wetzels JF.
Diabetes Care. 1996 ;19:775-6, and some other references) and is certainly
due to haemolysis.
I would have thought a low-grade haemolytic process would be best picked up
using measurement of haptoglobin.
Eric
Dr. Eric S. Kilpatrick
Consultant in Chemical Pathology
Hull Royal Infirmary
Anlaby Rd
Hull HU3 2JZ
Tel: 01482-607708
Fax: 01482-607752
----- Original Message -----
From: Mohammad Al-Jubouri <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, October 23, 2003 10:18 PM
Subject: Re: Dapsone lowering effect on HbA1c
> HbA1c was checked by HPLC and DCA2000 with excellent
> concordance of results. This is a real phenomenon.
>
> thanks
>
> Mohammad
>
> --- "Bakker, A J" <[log in to unmask]> wrote: > It
> would be of interest how you measure HbA1c. The
> > effect might be different
> > in HPLC or immunochemistry methods, so the question
> > is if this lowering is
> > real or artifical.
> >
> > To diagnose subclinical haemolysis, you may also
> > look at haptoglobin
> >
> > Andries
> >
> > Dr. A. J. Bakker, Klinisch chemicus,
> > St. Klinisch Chemisch Laboratorium,
> > Postbus 850,
> > 8901 BR LEEUWARDEN.
> > Tel.: 058-2888444
> > Fax: 058-2882227
> > E-mail: [log in to unmask]
> >
> >
> > > -----Oorspronkelijk bericht-----
> > > Van: Mohammad Al-Jubouri
> > [SMTP:[log in to unmask]]
> > > Verzonden: woensdag 22 oktober 2003 16:31
> > > Aan: [log in to unmask]
> > > Onderwerp: Dapsone lowering effect on HbA1c
> > >
> > > Type 2 diabetic had HbA1c of > 7.0%, was started
> > on
> > > dapsone for dermatitis herpetiformis, his HbA1c
> > came
> > > down to 3.7% despite documented hyperglycaemia.
> > HbA1c
> > > is now consistently below 4.0%. His total
> > haemoglobin
> > > is 12.7 g/dL, retics 2.2% and normal bilirubin.
> > Can
> > > this be attributed solely to dapsone-induced
> > > subclinical haemolysis? Can dapsone interfer
> > directly
> > > with protein glycation? How to diagnose
> > subclinical
> > > haemolysis if LDH, Hb, bilirubin and retics are
> > all
> > > normal, or would this exclude it?
> > >
> > > thanks
> > >
> > > Mohammad
> > >
> > >
> > > =====
> > > Dr. M A Al-Jubouri
> > > Consultant Chemical Pathologist
> > >
> > >
> >
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> =====
> Dr. M A Al-Jubouri
> Consultant Chemical Pathologist
>
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