ABSTRACT
A wide variety of drugs and substances have the potential to damage the respiratory system by different mechanisms. Clofazimine is an anti-leprosy drug that is normally only prescribed for a few years. It has a very long half-life, and crystalline deposition of the drug in various tissues has been documented. But up to now, no fatalities due to pulmonary damage have been described. We report the case of a patient who took clofazimine for almost 27 years as off-label treatment for Melkersson-Rosenthal syndrome. He suffered from progressive dyspnea, productive cough, and occasional hemoptysis. X-ray and CT of the thoracic organs revealed extensive multilocular, compact, tumor-like infiltrates with central necrosis in both lungs. Pulmonary function tests showed restrictive impairment and manifest hypoxemia. Histology of lung biopsies revealed intense interstitial accumulation of histiocytes and marked deposition of crystalline foreign material. The patient died from progressive respiratory failure. Autopsy revealed crystalline deposition and a histiocytic reaction in many other parenchymal organs. Conclusion: Pulmonary parenchymal deposition of drug crystals is a rare mechanism of drug-induced pulmonary diseases. Long-standing, off-label use of clofazimine may cause severe destruction of the lungs and can be fatal.
Subject(s)
Clofazimine/adverse effects , Melkersson-Rosenthal Syndrome , Respiratory Insufficiency , Biopsy , Fatal Outcome , Hemoptysis , Humans , Male , Melkersson-Rosenthal Syndrome/chemically induced , Melkersson-Rosenthal Syndrome/drug therapyABSTRACT
Cheilitis granulomatosa (CG) is a rare disorder of unknown origin, which is characterized clinically by painless, recurrent or persistent swelling of 1 or both lips. Betel quids, composed of betel nuts (seeds of the Areca catechu), slake lime, and Piper betel leaf/or Piper betel inflorescence, are widely used in Asia and strongly associated with oral mucosal disease. It has also been found to be a cause of contact leukomelanosis because of its ingredients of various chemicals. We describe a case of CG induced by betel quid chewing.
Subject(s)
Dermatitis, Allergic Contact/etiology , Melkersson-Rosenthal Syndrome/chemically induced , Piper betle/adverse effects , Plant Components, Aerial/adverse effects , Adult , Areca , Dermatitis, Allergic Contact/diagnosis , Humans , Male , Mastication , Patch TestsABSTRACT
We present a case of Melkersson-Rosenthal syndrome that occurred in an adult patient who experienced intolerance to the food additives sodium benzoate and tartrazine. The main symptoms were the facial swelling, hypertrophy of the gums, and a typical infiltration of lymphocytes and plasma cells around the small vessels observed in the biopsy of the gums. No involvement of facial nerves was present, and other disorders of granulomatosis have been excluded. All clinical manifestations went into remission once the food additives were excluded from the usual diet.
