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胺碘酮治疗引起的罕见神经肌肉病毒性:病例报告

Uncommon neuromyopathy toxicity induced by amiodarone therapy: case report.

作者信息

El Bahri L, Bensied A, Nessnassi M, Fellat I, Cherti Mohamed

机构信息

Mohammed V University, Rabat, Morocco.

出版信息

Egypt Heart J. 2025 Mar 19;77(1):33. doi: 10.1186/s43044-025-00631-5.

Abstract

BACKGROUND

Amiodarone is an antiarrhythmic drug known for its potential side effects, one of which is neuromyopathy, though it remains relatively rare. This condition can present with muscle weakness, pain, and tremors, potentially leading to functional impairment. The exact mechanisms underlying amiodarone-induced neuromyopathy are not fully understood but may involve both direct muscle toxicity and effects on nerve conduction.

CASE PRESENTATION

We present the case of a 68-year-old man with symptomatic arrhythmogenic right ventricular dysplasia, receiving long-term amiodarone, experiencing bilateral leg pain and weakness associated with amiodarone use. On clinical examination, motor strength in the lower limbs was rated at 2/5, with decreased tactile sensation. The biological assessment showed normal level of creatine kinase and C-reactive protein. The spinal MRI was normal. Electromyography "EMG" revealed a non-length dependent sensorimotor demyelinating polyneuropathy. After discontinuing amiodarone, both mobility and function showed significant improvement.

CONCLUSION

These observations highlight the importance of performing neurologic examinations in patients treated with amiodarone to identify even rare complications, such as neuromyopathy. Importantly, neuromyopathy is often reversible following discontinuation of the drug.

摘要

背景

胺碘酮是一种抗心律失常药物,以其潜在的副作用而闻名,其中之一是神经肌病,尽管这种情况仍然相对罕见。这种病症可能表现为肌肉无力、疼痛和震颤,可能导致功能障碍。胺碘酮诱发神经肌病的确切机制尚不完全清楚,但可能涉及直接的肌肉毒性和对神经传导的影响。

病例介绍

我们报告一例68岁男性,患有症状性致心律失常性右室发育不良,长期服用胺碘酮,出现与使用胺碘酮相关的双侧腿痛和无力。临床检查时,下肢肌力评为2/5,触觉减退。生物学评估显示肌酸激酶和C反应蛋白水平正常。脊柱MRI正常。肌电图(EMG)显示为非长度依赖性感觉运动性脱髓鞘性多发性神经病。停用胺碘酮后,活动能力和功能均有显著改善。

结论

这些观察结果强调了对接受胺碘酮治疗的患者进行神经系统检查以识别甚至罕见并发症(如神经肌病)的重要性。重要的是,停药后神经肌病通常是可逆的。

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本文引用的文献

1
Amiodarone-induced neuromyopathy in a geriatric patient.老年患者胺碘酮诱导的神经肌肉病。
BMJ Case Rep. 2020 Nov 4;13(11):e236620. doi: 10.1136/bcr-2020-236620.
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Amiodarone-induced hepatitis and polyneuropathy.胺碘酮诱发的肝炎和多发性神经病。
Korean J Intern Med. 2007 Sep;22(3):225-9. doi: 10.3904/kjim.2007.22.3.225.
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