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Question
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Which of these drugs does not cause a neuropathy mimicking CIDP?
Explanation
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Amiodarone causes a sensory motor neuropathy with demyelination on electrophysiology. It is related to prolonged duration of therapy. TNF- antagonists (Infliximab, etanercept and adalimumab) can cause chronic axonal and demyelinating neuropathies in addition to CNS demyelination. Interferon alfa and tacrolimus can cause axonal or demyelinating neuropathy. The immune check point inhibitors like pembrolizumab, ipilimumab can cause severe demyelinating neuropathies like GBS and CIDP with CSF abnormalities. Neuropathy due to drugs require stopping of offending medication and immunomodulation therapy. Penicillamine is associated with myasthenia gravis.
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Reference
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Katirji B. Disorders of Peripheral Nerves. Bradley and Daroffs Neurology in Clinical Practice. 2022. Ch 1061853.
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Option 1
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Is Correct (Option 1):
Tacrolimus
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Option 2
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Is Correct (Option 2):
Pembrolizumab
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Option 3
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Is Correct (Option 3):
Amiodarone
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Option 4
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Is Correct (Option 4):
D-Penicillamine
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