Propylthiouracil and peripheral neuropathy

Abstract

SUMMARY -Peripheral neuropathy is a rare manifestation in hyperthyroidism. We describe the neurological manifestations of a 38 year old female with Graves' disease who developed peripheral neuropathy in the course of her treatment with propylthiouracil. After the drug was tapered off, the neurological signs disappeared. Therefore, we call attention for a possible toxic effect on peripheral nervous system caused by this drug.KEY WORDS: hyperthyroidism, peripheral neuropathy, propylthiouracil.Neuropatía periférica induzida por propiltiouracil.RESUMO -Os autores descrevem o caso de urna paciente de 38 anos de idade, com doença de Graves, que desenvolveu sinais e sintomas compatíveis a polineuropatia sensitivomotora durante o tratamento com propiltiouracil. Após a retirada gradual da referida droga, o quadro neurológico desapareceu por completo. Sendo extremamente incomum o surgimento de neuropatía periférica secundaria ao hipertiroidismo e em vista do uso corriqueiro do propiltiouracil no tratamento dessa enfermidade endocrina, os autores chamam a atenção para a possível participação do fármaco como agente etiológico de neuropatía periférica em enfermos usuários do propiltiouracil. PALAVRAS-CHAVE: hipertiroidismo, neuropatía periférica, propiltiouracil.Hyperthyoroidism is a common disease in medical practice and is frequently associated to various neurological and neuromuscular disorders, the commonest of them is proximal myopathy 1. Thyrotoxic neuropathy is extremely rare and this association is questioned by several authors. Some publications describe this entity clinically and electrophysiologically i» 2 .5. It was first described as Basedow's paraplegia by Charcot in 1889, and Joffroy in 18941.Neurological disturbances associated to propylthiouracil (PTU) are rare. Vertigo, paresthesia, dysesthesia are described but there is no known direct neurotoxic effect of the drug capable of determining neuropathy i.Meyer-Gessner and colleagues 4 , in a series of 1256 patients during antithyroid treatment, reported peripheral neuropathy in 0.7%, of cases, not mentioning which drug was implicated in this disorder. In this brief report