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Black cartilage after therapy with levodopa and methyldopa
1Department of Clinical Pathology, University of Lund, Malmö General Hospital, Sweden.
Archives of Pathology & Laboratory Medicine
|May 1, 1994
Summary
Levodopa treatment for Parkinson's disease can cause harmless but irreversible pigmentation in rib cartilage. This dopa pigmentation is specific to cartilage and distinct from ochronosis.
Area of Science:
- Biochemistry
- Pathology
- Pharmacology
Background:
- Pigmented rib cartilage has been observed in autopsy cases.
- Previous studies have not fully elucidated the cause or nature of this pigmentation.
Purpose of the Study:
- To investigate the cause of pigmented rib cartilage in patients treated with levodopa or methyldopa.
- To characterize the pigment and its location within the cartilage.
Main Methods:
- Analysis of 14 autopsy cases with pigmented rib cartilage.
- Chromatographic demonstration of levodopa in cartilage.
- Histological examination of cartilage and other tissues.
Main Results:
- Twelve patients treated with levodopa (Parkinson's disease) and two with methyldopa (hypertension) had pigmented rib cartilage.
- Thirty-two percent of Parkinson's disease autopsy cases showed pigmented rib cartilage.
- Pigment was found in the matrix and necrotic chondrocytes; levodopa was present in cartilage.
Conclusions:
- Levodopa treatment is associated with rib cartilage pigmentation, likely due to a pigmented metabolite.
- This 'dopa pigmentation' is specific to cartilage, differs from ochronosis, and appears harmless but irreversible.