Pais Anthony V, Pereira Savio, Garg Isha, Stephen John, Antony Meryl, Inchara Y K
Department of Surgery, St John's Medical College Hospital, Sarjapur Road, Koramangala, Bangalore, India.
Lepr Rev. 2004 Jun;75(2):171-6.
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.
我们报告了一例氯法齐明治疗引起腹部并发症的病例，这些并发症包括淋巴结、大网膜和腹膜出现黑色色素沉着。一名44岁女性，患有瘤型麻风，2年前有氯法齐明不良反应史，现患有直肠乙状结肠交界处腺癌。剖腹探查发现肿瘤无法切除，肠管、浆膜和腹膜有色素沉着。第二次手术进行了横袢结肠造口术，送检的肠系膜淋巴结活检冰冻切片显示有典型的氯法齐明晶体。尽管氯法齐明多年来广泛用于麻风病治疗，但尚无证据表明其具有致癌性，该病例也未提供其使用与患者癌症之间存在关联的证据。除用于麻风病治疗外，氯法齐明还可用于治疗播散性鸟分枝杆菌复合群感染、溃疡分枝杆菌引起的布鲁里溃疡，偶尔也用于其他分枝杆菌感染。了解上述罕见副作用可能有助于对此类病例进行临床评估和管理，包括避免不必要的剖腹探查。
