Kawagashira Y, Watanabe H, Oki Y, Iijima M, Koike H, Hattori N, Katsuno M, Tanaka F, Sobue G
Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
J Neurol Neurosurg Psychiatry. 2007 Aug;78(8):899-901. doi: 10.1136/jnnp.2006.111302.
A 57-year-old man with type 2 diabetes mellitus for 10 years showed progressive loss of muscle strength in both legs, pain and muscle atrophy in the femoral region and significant weight loss. On admission, he could not stand alone and used a wheelchair. He also complained of severe pain in the lower extremities. He was diagnosed with proximal diabetic neuropathy (PDN) by characteristic clinical and electrophysiological features. Intravenous immunoglobulin therapy (IVIg 0.4 g/kg x 5 days) markedly reduced the severe pain and muscle weakness in the legs. Eventually, pain assessed by the Visual Analogue Scale was relieved by 80% and muscle strength was also well recovered, thereby enabling the patient to walk with a cane. The present case suggests that IVIg therapy may be effective for the relief of pain in PDN.
一名患有2型糖尿病10年的57岁男性，出现双下肢肌肉力量进行性丧失、股部疼痛和肌肉萎缩以及显著体重减轻。入院时，他无法独自站立，需使用轮椅。他还抱怨下肢剧痛。根据典型的临床和电生理特征，他被诊断为近端糖尿病性神经病变（PDN）。静脉注射免疫球蛋白治疗（IVIg 0.4 g/kg×5天）显著减轻了腿部的剧痛和肌肉无力。最终，通过视觉模拟评分法评估的疼痛缓解了80%，肌肉力量也得到了很好的恢复，从而使患者能够拄着拐杖行走。本病例表明，IVIg治疗可能对缓解PDN的疼痛有效。
