Amiodarone neuropathy clinico-pathological study of two cases

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.