Open-access Neuropatia pela amiodarona: estudo clínico-patológico de dois casos

Amiodarone neuropathy clinico-pathological study of two cases

Resumos

Dois pacientes, uma mulher de 40 anos e um homem de 75 anos, apresentavam polineurite sensítivo-motora, cujo único antecedente era o uso de amiodarona há 4 e 6 anos respectivamente. O ENMG revelou quadro neuropático tipo axonal. A biópsia do nervo sural mostrou rarefação axonal, mielínica e amielínica, bem como inclusões lamelares osmiofílicas nas células de Schwann e no endotélio venular. Com a retirada da amiodarona houve regressão da polineurite. À semelhança do que foi descrito na neuropatia pelo maleato de perhexiline e pela cloroquina, a amiodarona constitui importante fator de indução de neuro-lipidose medicamentosa.


Two patients, a 40-year-old woman and a 75-year-old man, were investigated due to a chronic polyneuritis. Amiodarone was used by them to treat refractory cardiac arrythmia since 4 and 6 years before, respectively. The EMG study showed an axonal neuropathy. The light and electronmicroscopical study of sural nerve displayed a losse of large myelinated fibers and a marked reduction of unmyelinated axons, associated with osmiophilic lamellated inclusions in Schwann cells and endothelial venulae. The interruption of amiodarone therapy improved neuropathy. Considered together with similar reports in perhexiline neuropathy and with chloroquine induced neuropathy this would stress the importance of these new drug-induced neurolipidosis.


Neuropatia pela amiodarona: estudo clínico-patológico de dois casos

Amiodarone neuropathy clinico-pathological study of two cases

J. A. Maciel Jr.I; L. QueirozII

IFaculdade de Ciências Médicas da UNICAMP: Professor Assistente Doutor do Departamento de Neurologia

IIFaculdade de Ciências Médicas da UNICAMP: Professor Assistente Doutor do Departamento de Neurologia; Professor Assistente Doutor do Departamento de Anatomia Patológica

RESUMO

Dois pacientes, uma mulher de 40 anos e um homem de 75 anos, apresentavam polineurite sensítivo-motora, cujo único antecedente era o uso de amiodarona há 4 e 6 anos respectivamente. O ENMG revelou quadro neuropático tipo axonal. A biópsia do nervo sural mostrou rarefação axonal, mielínica e amielínica, bem como inclusões lamelares osmiofílicas nas células de Schwann e no endotélio venular. Com a retirada da amiodarona houve regressão da polineurite. À semelhança do que foi descrito na neuropatia pelo maleato de perhexiline e pela cloroquina, a amiodarona constitui importante fator de indução de neuro-lipidose medicamentosa.

SUMMARY

Two patients, a 40-year-old woman and a 75-year-old man, were investigated due to a chronic polyneuritis. Amiodarone was used by them to treat refractory cardiac arrythmia since 4 and 6 years before, respectively. The EMG study showed an axonal neuropathy. The light and electronmicroscopical study of sural nerve displayed a losse of large myelinated fibers and a marked reduction of unmyelinated axons, associated with osmiophilic lamellated inclusions in Schwann cells and endothelial venulae. The interruption of amiodarone therapy improved neuropathy. Considered together with similar reports in perhexiline neuropathy and with chloroquine induced neuropathy this would stress the importance of these new drug-induced neurolipidosis.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Agradecimento - A Dra. A. Nucci, pela avaliação ENMG.

Departamento de Neurologia Faculdade de Ciências Médicas, UNICAMP - Caixa Postal 6111 - 13083 Campinas SP - Brasil.

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Datas de Publicação

  • Publicação nesta coleção
    01 Jun 2011
  • Data do Fascículo
    Dez 1989
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