Intra-abdominal, crystal-storing histiocytosis due to clofazimine in a patient with lepromatous leprosy and concurrent carcinoma of the colon.

Abstract

We report a case with abdominal complications of clofazimine treatment which included blackish discolouration of the lymph nodes, omentum and peritoneum. A 44-year-old female with lepromatous leprosy and a history of adverse reaction to clofazimine 2 years previously, presented with rectosigmoid junction adenocarcinoma. Laparotomy revealed an inoperable tumour with pigmentation of the bowel, serosa and peritoneum. A second operation had o be performed for transverse loop colostomy and a mesenteric lymph node biopsy sent for frozen section showed typical clofazimine crystals. Despite widespread use for many years in the treatment of leprosy, this drug is not known to be carcinogenic and this case provides no evidence for an association or link between its use and the patient's cancer. Apart from its use in leprosy, clofazimine may be used in the treatment of disseminated Mycobacterium avium-intracellulare infection, Buruli ulcer due to M. ulcerans and occasionally in other mycobacterial infections. An awareness of the rare side-effect described above may help in the clinical assessment and management of such cases, including the avoidance of unnecessary laparotomy.

• Authors: Anthony V Pais, Savio Pereira, Isha Garg, John Stephen, Meryl Antony, Y K Inchara
• Journal: Leprosy review (Lepr Rev) Vol. 75 Issue 2 Pg. 171-6 (Jun 2004) ISSN: 0305-7518 [Print] England
• PMID: 15282969 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Leprostatic Agents
• Clofazimine

Topics

• Abdominal Pain (chemically induced, diagnosis)
• Adenocarcinoma (complications)
• Adult
• Clofazimine (adverse effects)
• Colonic Neoplasms (complications)
• Crystallization
• Female
• Histiocytosis (chemically induced, diagnosis)
• Humans
• Leprostatic Agents (adverse effects)
• Leprosy, Lepromatous (complications, drug therapy)