Vasculitic Neuropathy Following Exposure to a Glyphosate-based Herbicide

Abstract

We herein report a case of peripheral neuropathy following exposure to large amounts of glyphosate-based herbicide. A 70-year-old man suffered from pain and purpura in the left sole following exposure to glyphosate-based herbicide. Pain and purpura spread to the opposite side and increased in severity. Mild weakness of the lower limbs was also observed. A sural nerve biopsy revealed the infiltration of lymphocytes around small vessels in the epineurium with numerous eosinophils, deposition of hemosiderins and focal axonal degeneration, compatible with findings of vasculitic neuropathy. Glyphosate-based herbicides should be recognized as a causative agent of vasculitic neuropathy.

Keywords: cutaneous vasculitis; glyphosate-based herbicides; systemic vasculitis; vasculitic neuropathy.

Figure.

(A) The patient’s distal portion of the lower extremities. Livedo reticularis in the bilateral sole was observed. (B) A transverse section of the sural nerve biopsy stained with toluidine blue exhibited focal myelinated fiber loss (arrows). (C-E) Hematoxylin and Eosin staining. Infiltration of lymphocytes around the small vessels (C), including numerous eosinophils (arrowheads) (D). Deposition of hemosiderins (arrows) in the epineurium (E). The asterisks indicate the profile of small vessels in C and the endoneurium in E. Scale bar= (B) 50 μm; (C) 100 μm; (D) 20 μm; (E) 50 μm.