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
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Dr. M A Al-Jubouri
Consultant Chemical Pathologist
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