Nitrofurantoin and peripheral neuropathy with megaloblastic anaemia.

Morris, John

doi:10.1136/jnnp.29.3.224

Cited by 15 publications

(2 citation statements)

References 20 publications

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“…11 Most of the reported cases were in patients who had medical conditions associated with peripheral neuropathy (renal failure, diabetes melilites, and anemia) and whose neuropathy was probably unmasked by nitrofurantoin. 12,13 Our patient had multiple mononeuropathies (also known as mononeuritis multiplex), rather than a length-dependent neuropathy, which raised suspicion for an inflammatory or vasculitic process, not previously reported with nitrofurantoin. There is only a case series of 2 patients who presented with non-length-dependent neuropathic pain after therapy with nitrofurantoin and demonstrated substantial morphologic changes of aggregated swellings of terminal nerve fibers in their skin biopsy.…”

Section: Discussionmentioning

confidence: 67%

Nitrofurantoin and Minocycline–Associated Vasculitic Neuropathy: Case Reports and Literature Review

Aladawi

Shelly

Dyck

et al. 2022

Journal of Clinical Neuromuscular Disease

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Background: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. Methods:We present the first reported case of nitrofurantoinassociated and an illustrative case of minocyclineassociated vasculitic neuropathy, with a review of the literature. Results: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. Conclusions:Medications should be considered as a trigger for medication-induced vasculitic neuropathy. Accurate diagnosis would ensure timely treatment.

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Section: Discussionmentioning

confidence: 67%

Nitrofurantoin and Minocycline–Associated Vasculitic Neuropathy: Case Reports and Literature Review

Aladawi

Shelly

Dyck

et al. 2022

Journal of Clinical Neuromuscular Disease

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“…It is a synthetic antimicrobial derived from furan by the addition of a nitro group and a side chain containing hydantoin. 2 Its antibacterial spectrum is broad and is particularly effective against Escherichia coli and Klebsiella and Enterobacter species, hence its use for the treatment of urinary tract infections. Nitrofurantoin is excreted and concentrated in the urine.…”

Section: Commentmentioning

confidence: 99%

Peripheral Nerve Toxic Effects of Nitrofurantoin

et al. 2012

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To investigate the role of skin biopsy in nitrofurantoin peripheral neuropathy. Design: We describe the clinical features and skin biopsies of 2 cases of non-length-dependent smallfiber neuropathy/ganglionopathy attributable to nitrofurantoin. Setting: Clinical evaluation and skin biopsies were performed at a tertiary teaching hospital in Baltimore, Maryland. Patients: A 59-year-old woman with disabling generalized dysesthesia and a 53-year-old woman with progressive burning pain in the perineum and extremities. Main Outcome Measures: Slow or incomplete recovery and possibly irreversible damage. Results: The neuropathy was neither dose dependent nor associated with impaired renal function. Results from nerve conduction studies were normal. Skin biopsies revealed distinctive morphologic changes with clustered terminal nerve swellings without evidence of nerve fiber degeneration. Conclusions: These distinct morphologic changes associated with nitrofurantoin have not been previously reported to our knowledge. Skin biopsy appears to be helpful in confirming the diagnosis in these patients.

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