青少年 1 型糖尿病相关神经性恶病质。
Neuropathic cachexia associated with type 1 diabetes in an adolescent girl.
机构信息
The Saul R. Korey, Department of Neurology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.
出版信息
Pediatr Neurol. 2013 Oct;49(4):282-5. doi: 10.1016/j.pediatrneurol.2013.04.010. Epub 2013 Aug 6.
BACKGROUND
Diabetic neuropathic cachexia is a rare and little understood variant of diabetic neuropathy. It predominantly affects men with type 2 diabetes mellitus in their sixth to seventh decades of life and is characterized by the subacute onset of a painful sensory neuropathy, rapid weight loss, and psychiatric comorbidity.
METHODS
We present the only female pediatric case described to date, and one of only a handful of cases reported to affect type 1 diabetics.
RESULTS
In this patient a diagnosis of diabetic neuropathic cachexia was based on the rapid onset of severe allodynic pain, polyneuropathy, and marked weight loss in the setting of poorly controlled diabetes, without evidence of end-organ disease and exclusion of other known causes of neuropathy.
CONCLUSIONS
Diabetic neuropathic cachexia is a complex neuroendocrinologic disorder characterized by profound weight loss, neuropathic pain, and mood disturbance. Electrodiagnostic abnormalities were pronounced showing a moderately severe generalized sensorimotor polyneuropathy.
背景
糖尿病性神经病理性恶病质是一种罕见且尚未被充分了解的糖尿病性神经病变变异。它主要影响六七十岁的 2 型糖尿病男性，其特征是亚急性起病的疼痛性感觉神经病、体重迅速减轻和精神共病。
方法
我们介绍了迄今为止描述的唯一女性儿科病例，也是少数报道的影响 1 型糖尿病患者的病例之一。
结果
在该患者中，糖尿病性神经病理性恶病质的诊断基于严重的痛觉过敏疼痛、多发性神经病和在控制不佳的糖尿病背景下明显的体重减轻，没有终末器官疾病的证据，并且排除了其他已知的神经病原因。
结论
糖尿病性神经病理性恶病质是一种复杂的神经内分泌紊乱，其特征是严重体重减轻、神经病理性疼痛和情绪障碍。电诊断异常明显，表现为中度严重的全身性感觉运动性多发性神经病。
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