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2010, Number 5

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Rev Med Inst Mex Seguro Soc 2010; 48 (5)

Peripheral neuropathy caused by leflunomide. A case reported with a brief review

Antonio-Valdiviezo A, Peña-Santos G, Martínez-Torres J

Language: Spanish
References: 11
Page: 567-570
PDF size: 31.52 Kb.


ABSTRACT

Background: leflunomide (LEF) is an immunomodulator derived from isoxazole It is an approved drug in the rheumatoid arthritis (RA). The peripheral neuropathy (PN) is a recognized side effect of some medications.
Clinical case: a 48 years woman with diabetes type 2 (DM2) and RA; with serum negative rheumatoid factor. She got nonsteroidal anti-inflammatories drugs, corticosteroid, methotrexate, sulfasalazine and chloroquine. Despite this, she was clinically within the functional class III and data of osteopenia. The treatment was switched to LEF, chloroquine and prednisone. After four months, she began with dysesthesia in the left cubital area, paresthesias in her right knee; and then in a progressive pattern others paresthesias, hyporeflexia and a decrease in the muscular strength. She was treated with cholestyramine, but her neuropathy did no improve. Severe segmental desmyelination polyneuropathy and retrograde axonal degeneration with predominance of the thoracic members over the pelvic members was reported in the electroneuro-physiological and electromyography studies.
Conclusions: it is advisable to perform electrophysiological studies in patients’ with DM2 before they get treatment with LEF.


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