ABSTRACT
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.
Subject(s)
Autopsy , Clofazimine/pharmacokinetics , Fatal Outcome , Female , Humans , Leprostatic Agents/pharmacokinetics , Leprosy, Lepromatous/drug therapy , Middle Aged , Tissue DistributionABSTRACT
Os autores fazem uma revisäo sobre os aspectos farmacológicos e mecanismos de açäo da clofazimina (CFZ) de um modo geral e, em particular, sobre seus efeitos no pioderma gangrenoso (PG). É feita também uma avaliaçäo sobre os diferentes métodos de tratamento utilizados no PG. Como ilustraçäo é demonstrado o caso de uma paciente de 13 anos de idade, feminina, natural e procedente do Maranhäo, portadora de PG, que foi tratada com 200 mg diários de CFZ, obtendo remissäo total do quadro em quatro semanas