Departement of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE.
Department of Neurology, Mayo Clinic, Rochester, MN.
J Clin Neuromuscul Dis. 2022 Dec 1;24(2):85-94. doi: 10.1097/CND.0000000000000404.
Vasculitic neuropathies usually present acutely to subacutely, with an asymmetric pattern, involving multiple peripheral nerve territories. Drug-induced vasculitis is an often overlooked etiology of vasculitic neuropathy.
We present the first reported case of nitrofurantoin-associated and an illustrative case of minocycline-associated vasculitic neuropathy, with a review of the literature.
The first patient is a 60-year-old woman who developed axonal sensorimotor peripheral neuropathy after nitrofurantoin use, with a superficial radial nerve biopsy confirming vasculitis. The second patient is a 23-year-old woman, with a history of acne vulgaris treated with minocycline, who presented with a subacute right common peroneal mononeuropathy followed by a left deep peroneal mononeuropathy, with elevated antinuclear, perinuclear-antineutrophil cytoplasmic, and myleoperoxidase antibodies, and MPO titers, and a sural nerve biopsy showing large arteriole vasculitis. Finally, we provide a comprehensive review of previously published cases.
Medications should be considered as a trigger for medication-induced vasculitic neuropathy. Accurate diagnosis would ensure timely treatment.
血管炎性神经病通常呈急性或亚急性起病，呈不对称模式，累及多个周围神经区域。药物相关性血管炎是血管炎性神经病一个常被忽视的病因。
我们报告首例报道的呋喃妥因相关性和一例米诺环素相关性血管炎性神经病病例，并进行文献复习。
第 1 例患者是一位 60 岁女性，在使用呋喃妥因后出现轴索性感觉运动性周围神经病，桡神经浅表活检证实为血管炎。第 2 例患者是一位 23 岁女性，患有寻常痤疮，曾接受米诺环素治疗，表现为亚急性右侧腓总神经单神经病，随后出现左侧腓深神经单神经病，伴有抗核抗体、核周抗中性粒细胞胞浆抗体和髓过氧化物酶抗体升高，以及髓过氧化物酶滴度升高，腓肠神经活检显示大动脉血管炎。最后，我们对之前发表的病例进行了全面回顾。
药物应被视为药物相关性血管炎性神经病的触发因素。准确的诊断将确保及时治疗。
