1型糖尿病患者同时进行胰腺-肾脏移植11年后出现双侧神经关节病。
BILATERAL NEUROARTHROPATHY 11 YEARS AFTER SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANT FOR TYPE 1 DIABETES MELLITUS.
作者信息
Ho Sebastian, Giddie Jasdeep, Dhatariya Ketan K
出版信息
AACE Clin Case Rep. 2019 Jan 17;5(4):e259-e262. doi: 10.4158/ACCR-2018-0408. eCollection 2019 Jul-Aug.
OBJECTIVE
To report a case of a man who developed bilateral Charcot arthropathic feet 11 years after a simultaneous pancreas-kidney transplant (SPKT) for type 1 diabetes mellitus (DM). The patient had remained normoglycemic after surgery.
METHODS
We present a retrospective review of the case notes and serial imaging.
RESULTS
The patient developed dense peripheral diabetic neuropathy due to poor glycemic control. His biochemical markers of DM all normalized following SPKT, and he was discharged by his primary and secondary care diabetes services. Eleven years later, he developed Charcot arthropathy in one foot and, within a month, the other foot as well.
CONCLUSION
Individuals with DM who had preoperative end organ diabetes-related damage who went into biochemical remission after SPKT may be at risk for future complications. They should not be discharged from specialist diabetes services, and they need continued education about foot care.
目的
报告一例1型糖尿病患者在接受胰肾联合移植（SPKT）11年后出现双侧夏科氏关节病足的病例。该患者术后血糖一直保持正常。
方法
我们对病例记录和系列影像学资料进行了回顾性分析。
结果
由于血糖控制不佳，该患者出现了严重的周围神经病变。胰肾联合移植后，他的所有糖尿病生化指标均恢复正常，他被初级和二级糖尿病护理机构出院。11年后，他一只脚出现了夏科氏关节病，一个月内，另一只脚也出现了。
结论
术前存在与糖尿病相关的终末器官损害且在胰肾联合移植后生化指标缓解的糖尿病患者可能有发生未来并发症的风险。他们不应从专科糖尿病护理机构出院，并且需要持续接受足部护理教育。
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