[Peripheral neuropathy during treatment with cimetidine]

Area of Science:

• Neurology
• Toxicology
• Immunology

Background:

• Cimetidine is a widely used histamine H2 receptor antagonist.
• Peripheral neuropathy is a potential adverse effect of various medications.

Observation:

• A patient developed symmetric motor neuropathy affecting all four limbs after initiating cimetidine.
• Symptoms included muscle pain and distal, lower-limb predominant motor deficits.

Findings:

• Electrophysiological and morphometric studies confirmed an axonal neuropathy.
• Histopathology revealed epineurial microvasculitis, suggesting immune-complex vasculitis as the likely cause.

Implications:

• This case highlights a potential drug-induced peripheral neuropathy associated with cimetidine.
• The findings suggest a specific pathogenic mechanism involving small-vessel vasculitis.