title: Peripheral nerve toxic effects of nitrofurantoin.
abstract: OBJECTIVE
  To investigate the role of skin biopsy in nitrofurantoin peripheral neuropathy.
  
  
  METHODS
  We describe the clinical features and skin biopsies of 2 cases of non-length-dependent small-fiber neuropathy/ganglionopathy attributable to nitrofurantoin.
  
  
  METHODS
  Clinical evaluation and skin biopsies were performed at a tertiary teaching hospital in Baltimore, Maryland.
  
  
  METHODS
  A 59-year-old woman with disabling generalized dysesthesia and a 53-year-old woman with progressive burning pain in the perineum and extremities.
  
  
  METHODS
  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.
authors.affiliation: Department of Neurology, The Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287, USA.
authors.forename: Ik Lin
authors.initials: IL
authors.lastname: Tan
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Polydefkis
authors.forename: Gigi J
authors.initials: GJ
authors.lastname: Ebenezer
authors.forename: Peter
authors.initials: P
authors.lastname: Hauer
authors.forename: Justin C
authors.initials: JC
authors.lastname: McArthur
mesh_terms: D000588:Amines / Q000627:therapeutic use; D000700:Analgesics / Q000627:therapeutic use; D000892:Anti-Infective Agents, Urinary / Q000009:adverse effects* / Q000627:therapeutic use; D001706:Biopsy; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D018856:Cystitis, Interstitial / Q000150:complications / Q000188:drug therapy; D000068736:Duloxetine Hydrochloride; D005260:Female; D000077206:Gabapentin; D006801:Humans; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D009460:Neurologic Examination; D009582:Nitrofurantoin / Q000009:adverse effects* / Q000627:therapeutic use; D010292:Paresthesia / Q000139:chemically induced / Q000473:pathology; D010502:Perineum / Q000473:pathology; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000473:pathology*; D011565:Psoriasis / Q000150:complications; D012867:Skin / Q000473:pathology; D013876:Thiophenes / Q000627:therapeutic use; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000150:complications / Q000188:drug therapy; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
chemical_list: D000588:Amines; D000700:Analgesics; D000892:Anti-Infective Agents, Urinary; D003509:Cyclohexanecarboxylic Acids; D013876:Thiophenes; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D000068736:Duloxetine Hydrochloride; D009582:Nitrofurantoin