Lympidem (a coumarin derivative) induced reversible hepatotoxicity in an adult Sri Lankan.

Lympidem is a coumarin derivative which is advocated for treatment of mainly chronic lymphedema by the manufacturer. Since its introduction there had been several reports with regard to coumarin-induced hepatotoxicity from Europe. We report an adult Sri Lankan middle-aged female who presented with abnormal liver functions due to Lympidem, which resulted in discontinuation of the drug, while no other etiology could be found.

Total agranulocytosis caused by dapsone therapy for tuberculoid leprosy--an unappreciated serious side effect of anti-leprosy treatment with clinical implications.

Dapsone-induced agranulocytosis is a rare but potentially fatal adverse effect of treatment for tuberculoid leprosy. Publications distributed by the WHO Leprosy Elimination Campaign for patient information on leprosy do not contain any advice or guidelines for post-dapsone therapy follow-up. As a result of this major deficiency, the local anti-leprosy campaign in Sri Lanka has no such guidelines on dapsone therapy for leprosy patients.