Peripheral neuropathy induced by amiodarone chlorhydrate. A clinicopathological study

Area of Science:

• Neurology
• Toxicology
• Pathology

Background:

• Amiodarone is a widely used antiarrhythmic drug.
• Neuropathy is a potential adverse effect of amiodarone therapy.

Observation:

• Four patients developed sensorimotor neuropathy with distal predominance during amiodarone treatment.
• Nerve conduction studies revealed significantly decreased nerve conduction velocities.
• Two patients experienced other amiodarone-related side effects.

Findings:

• Pathological examination of nerve tissue showed predominant axonal degeneration in three cases.
• One case exhibited segmental demyelination and remyelination, suggesting secondary demyelination.
• Numerous lysosomal inclusions were identified in Schwann cells, fibroblasts, endothelial cells, and perineural cells, consistent with drug-induced lipidosis.

Implications:

• Amiodarone-induced neuropathy is characterized by axonal damage and lysosomal inclusions.
• Discontinuation of amiodarone may lead to improvement in neuropathy symptoms.
• Further research is needed to elucidate the exact mechanisms underlying amiodarone neuropathy and identify responsible factors.