A rare case of pure neuritic leprosy with hereditary spherocytosis: implications for dapsone use

We present a case of a 19-year-old female with the rare co-occurrence of pure neuritic leprosy (PNL) and hereditary spherocytosis (HS). Presenting with tingling, numbness, and sensory loss in her left hand but no skin lesions, she was diagnosed with PNL. Laboratory findings revealed HS, characterized by haemolysis-prone spherical RBCs. The coexistence of these conditions posed unique challenges, especially with dapsone, which can induce haemolytic anaemia. The patient was treated with rifampicin, ofloxacin, clofazimine, and prednisolone, excluding dapsone to prevent haemolysis. This case highlights the need for comprehensive diagnostics and a multidisciplinary approach to manage complex cases involving leprosy and haemolytic disorders. Further studies are required to establish detailed management guidelines for such rare and concurrent conditions.