Amiodarone‐Induced Neuropathy with chronic inflammatory demyelinating polyneuropathy‐like presentation. Issue 3 (27th February 2020)

• Record Type: Journal Article
• Authors: Okhovat, Ali Asghar; Saffar, Hiva; Fatehi, Farzad
• Other Names: Takeshima Takao guestEditor.
• Is Part Of: Neurology and clinical neuroscience. Volume 8:Issue 3(2020:May)
• Page Start: 160
• Page End: 163
• Publication Date: 2020-02-27
• Subjects: Amiodarone neurotoxicity -- chronic inflammatory demyelinating polyradiculoneuropathy -- chronic inflammatory demyelinating polyneuropathy; Neurology -- Periodicals; Neurosciences -- Periodicals; 616.8
• DOI: 10.1111/ncn3.12373
• Languages: English
• ISSNs: 2049-4173

Abstract

Abstract: Long‐term administration of amiodarone may have various neurological complications and systemic involvement. Herein, we report a 46‐year‐old male patient who was admitted as a result of paresthesia and progressive four‐limb weakness started six months before. Spiral chest CT scan showed bilateral hyper‐dense consolidations predominately seen in peripheral and lower lobes. We checked the serum level of amiodarone that was 3.1 mg/L (therapeutic range: 1.5 and 2.5 µg/mL). According to the characteristic pulmonary findings in lung CT scan, demyelinating polyneuropathy, and lack of response to treatment, with the suspicion of amiodarone toxicity, CT‐guided percutaneous core needle biopsy was performed. The pathological assessment revealed chronic interstitial inflammation and fibrosis, and exudation of macrophages with finely cytoplasmic vacuolization associated with hyperplasia of type II pneumocytes in alveoli with necrosis. These findings are consistent with amiodarone‐induced pulmonary toxicity. Chronic use of amiodarone may present as a CIDP‐like presentation, which may be overlooked if clinical suspicion is not high upon presentation.