Jadhav M V, Sathe A G, Deore S S, Patil P G, Joshi N G
Department of Pathology, BJ Medical College, Pune.
Indian J Pathol Microbiol. 2004 Apr;47(2):281-3.
There are very few autopsy studies available on systemic distribution of clofazimine, a drug with anti-mycobacterial activity, used in multidrug therapy (MDT) regimen of leprosy and in erythema nodosum leprosum (ENL). An autopsy study was done on a 45 year old female of lepromatous leprosy (LL) on MDT and long term high dosage of clofazimine. Patient succumbed to intractable abdominal pain, diarrhoea, hypokalemia following clofazimine treatment. Autopsy study revealed yellowish brown discoloration of skin, viscera and body fluids. Chemical extraction of the drug revealed the highest concentration of the drug in jejunum (1.5mg/gm),followed by spleen (1.2mg/gm), pancreas (0.4mg/gm), adrenal (0.25mg/gm), liver (0.21mg/gm), and less than 0.2mg/gm in lung, fat, large intestine and stomach. It can be inferred from the present study that the drug is absorbed from the jejunum and gets deposited in fat, reticulo-endothelial cells (R-E cells) and hepatocytes. The drug is best demonstrated in cryostat sections and is lost partly during tissue processing and staining. The drug toxicity can be fatal as seen in the present case.
关于氯法齐明的全身分布情况，现有尸检研究非常少。氯法齐明是一种具有抗分枝杆菌活性的药物，用于麻风病的多药联合治疗（MDT）方案以及麻风结节性红斑（ENL）的治疗。对一名45岁接受MDT且长期高剂量服用氯法齐明的瘤型麻风（LL）女性患者进行了尸检研究。该患者在氯法齐明治疗后死于顽固性腹痛、腹泻和低钾血症。尸检研究显示皮肤、内脏和体液呈黄褐色变色。对该药物进行化学提取后发现，空肠中药物浓度最高（1.5mg/g），其次是脾脏（1.2mg/g）、胰腺（0.4mg/g）、肾上腺（0.25mg/g）、肝脏（0.21mg/g），而肺、脂肪、大肠和胃中的浓度低于0.2mg/g。从本研究可以推断，该药物从空肠吸收，并沉积在脂肪、网状内皮细胞（R-E细胞）和肝细胞中。该药物在低温恒温器切片中显示最佳，在组织处理和染色过程中会部分丢失。如本病例所示，药物毒性可能是致命的。
