Morphological study of peripheral nerve changes induced by chloroquine treatment

Area of Science:

• Neurology
• Toxicology
• Pathology

Background:

• Chloroquine is used for connective tissue diseases and malaria prophylaxis.
• Neuromyopathy is a potential adverse effect of chloroquine treatment.
• Understanding the specific nerve involvement is crucial for patient management.

Purpose of the Study:

• To investigate the morphological changes in nerve biopsies from patients with suspected chloroquine-induced neuromyopathy.
• To identify the cellular targets of chloroquine toxicity in peripheral nerves.

Main Methods:

• Nerve biopsies were performed on four patients with suspected chloroquine neuromyopathy.
• Morphological and ultrastructural studies were conducted on the biopsy samples.

Main Results:

• Segmental demyelination and remyelination were observed in all cases.
• Cytoplasmic inclusions were found in Schwann cells, perineurial cells, endothelial cells, and interstitial cells, but not in axons.
• Curvilinear profiles and perineurial calcifications were noted in some cases.

Conclusions:

• Chloroquine neuropathy appears to primarily involve Schwann cells.
• The observed morphological changes provide insights into the pathogenesis of chloroquine-induced nerve damage.