糖尿病患者严重的直立性低血压可能不是由于糖尿病自主神经病变引起的。
Severe orthostatic hypotension in a diabetic patient may not be due to diabetic autonomic neuropathy.
机构信息
Department of Diabetes and Metabolism, The Royal London Hospital, Whitechapel, London.
出版信息
Clin Med (Lond). 2011 Jun;11(3):290-1. doi: 10.7861/clinmedicine.11-3-290.
Abstract
This lesson describes an unusual case of a man who was recently diagnosed with type 1 diabetes and who presented with severe orthostatic hypotension. As his diabetes was recent in onset, well controlled, and he had no other signs of microvascular disease, other causes of orthostatic hypotension were sought. His serum and cerebrospinal fluid were strongly positive for Borrelia burgdorferi IgG, suggesting a diagnosis of Lyme neuroborreliosis. Autonomic instability in Lyme, while rare, has been previously reported.
摘要
本课程描述了一例不常见的病例，一名近期被诊断为 1 型糖尿病的男性患者，伴有严重的体位性低血压。由于他的糖尿病近期发病且控制良好，且没有其他微血管疾病的迹象，因此寻找其他引起体位性低血压的原因。他的血清和脑脊液对伯氏疏螺旋体 IgG 呈强阳性，提示莱姆神经Borreliosis 感染的诊断。莱姆病自主神经不稳定虽然罕见，但以前已有报道。
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本文引用的文献
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Int J Cardiol. 2008 Sep 16;129(1):15-21. doi: 10.1016/j.ijcard.2008.01.044. Epub 2008 May 27.
2
The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America.莱姆病、人粒细胞无形体病和巴贝斯虫病的临床评估、治疗及预防：美国传染病学会临床实践指南
Clin Infect Dis. 2006 Nov 1;43(9):1089-134. doi: 10.1086/508667. Epub 2006 Oct 2.
3
Intestinal pseudoobstruction in acute Lyme disease: a case report.急性莱姆病中的肠道假性梗阻：一例报告
Am J Gastroenterol. 1998 Jul;93(7):1179-80. doi: 10.1111/j.1572-0241.1998.00361.x.
4
[Thoraco-abdominal manifestation of stage II Lyme neuroborreliosis].[二期莱姆病神经螺旋体病的胸腹表现]
Nervenarzt. 1998 Apr;69(4):296-9. doi: 10.1007/s001150050273.
5
Histopathology of clinical phases of human Lyme disease.人类莱姆病临床阶段的组织病理学
Rheum Dis Clin North Am. 1989 Nov;15(4):691-710.
6
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