LEPROSY
Leprosy Review
0305-7518
British Leprosy Relief Association
Colchester, UK
17-1176
0305-7518/04/064053+06
10.47276/lr.75.2.171
Case Report
Intra-abdominal, crystal-storing histiocytosis due to clofazimine in a patient with lepromatous leprosy and concurrent carcinoma of the colon
A. V. Pais et al.
Intra-abdominal, crystal-storing histiocytosis
PereiraSavio
aGargIsha
bStephenJohn
cAntonyMeryl
cIncharaY. K.
ba
Department of Surgery
b
Department of Pathology
c
Department of Dermatology, St John’s Medical College Hospital, Sarjapur Road, Koramangala, Bangalore, India
Correspondence to: A. V. Pais (Tel: +91 80 2065311; Fax: +91 80 553070)
01062004
75
2
171
176
16022004
© Lepra
2004
We report a case with abdominal complications of clofazimine treatment which included blackish discolouration of the lymph nodes, omentum and perito- neum. 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.