Amiodarone toxicity: Myopathy and neuropathy

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    The authors reported vacuolization of the Schwann cell cytoplasm, perineural inflammatory cell infiltration, demyelination, cellular degeneration. In another study that examined deltoid muscle specimens in a patient with amiodarone-induced myopathy, Fernando Roth et al. reported severe vacuolar myopathy presenting with small vacuoles in the muscle fibers and cellular swelling (Fernando Roth et al., 1990). Similar findings are also available for the thyroid gland (Nakazawa et al., 2008).

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    The myopathy is usually not as severe as seen in chloroquine and vacuoles are less prominent on routine light microscopy, but EM still usually demonstrates abnormal accumulation of myeloid and curvilinear bodies. Amiodarone is an antiarrhythmic medication that may cause a tremor or ataxia and neuromyopathy.39,40 The neuromyopathy is characterized by severe proximal and distal weakness along with distal sensory loss and reduced muscle stretch reflexes.

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From the Departments of Medicine, Pathology, and Neurology, University of California at Los Angeles School of Medicine; and the Division of Cardiology, Department of Medicine, Harbor-UCLA Medical Center.

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