Summary
Large single doses of isoniazid by mouth (1–2 g/kg) have been shown to produce in rats Wallerian degeneration visible with the light microscope from the third day onwards. By contrast, changes in axons are seen from 24 h onwards by electron microscopy. The earliest ultrastructural changes are associated with vacuoles appearing between axon and Schwann cells. These are large and focal, and often compress the axon. The adjacent axon may show changes in smooth ER, and in microtubular arrangement. Alterations in smooth membranes and in mitochondria are visible in Schwann cell cytoplasm, not necessarily related to the vacuole formation and axonal features.
It is suggested that INH neuropathy is essentially a multifocal axonal lesion.
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Jacobs, J.M., Miller, R.H., Whittle, A. et al. Studies on the early changes in acute isoniazid neuropathy in the rat. Acta Neuropathol 47, 85–92 (1979). https://doi.org/10.1007/BF00717029
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DOI: https://doi.org/10.1007/BF00717029