title: [Peripheral neuropathy caused by leflunomide. A case reported with a brief review].
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.
  
  
  METHODS
  A 48 years old 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 not improve. Severe segmental demyelination polyneuropathy and retrograde axonal degeneration with predominance of the thoracic members over the pelvic members was reported in the electroneurophysiological and electromyography studies.
  
  
  CONCLUSIONS
  It is advisable to perform electrophysiological studies in patients' with DM2 before they get treatment with LEF.
authors.affiliation: Hospital General de Zona 2, Tuxtla Gutiérrez, Instituto Mexicano del Seguro Social, Chiapas, Mexico.
authors.forename: Aquiles
authors.initials: A
authors.lastname: Antonio-Valdiviezo
authors.forename: Genaro
authors.initials: G
authors.lastname: Peña-Santos
authors.forename: Jorge
authors.initials: J
authors.lastname: Martínez-Torres
mesh_terms: D000276:Adjuvants, Immunologic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007555:Isoxazoles / Q000009:adverse effects*; D000077339:Leflunomide; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced*
chemical_list: D000276:Adjuvants, Immunologic; D007555:Isoxazoles; D000077339:Leflunomide