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新发 1 型糖尿病伴糖尿病酮症酸中毒性多发性神经病 1 例。

A case of polyneuropathy associated with diabetic ketoacidosis in new-onset type 1 diabetes.

机构信息

Department of Diabetes and Metabolism, Koseiren Tsurumi Hospital, Oita, Japan.

Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Oita, Japan.

出版信息

J Diabetes Investig. 2022 May;13(5):918-922. doi: 10.1111/jdi.13724. Epub 2021 Dec 29.

Abstract

Although diabetic peripheral neuropathy is the most common diabetic microangiopathic complication, several other neuropathy syndromes can occur in the context of diabetes. We describe a rare case of polyneuropathy associated with diabetic ketoacidosis in a patient with new-onset type 1 diabetes. A 42-year-old man with diabetic ketoacidosis was admitted to our hospital with complications of respiratory and renal failure requiring mechanical ventilation and hemodialysis, respectively. After diabetic ketoacidosis improved from the critical state, he developed upper- and lower-limb paralysis with sensory disturbances and pain, as well as right facial paralysis, left recurrent nerve paralysis, and left hypoglossal nerve paralysis. Autonomic nerve function was also impaired. As the pathophysiology, prevention, and treatment of polyneuropathy associated with diabetic ketoacidosis are unclear, the neurologic function of patients with diabetic ketoacidosis should be closely monitored.

摘要

尽管糖尿病周围神经病变是最常见的糖尿病微血管并发症,但在糖尿病的背景下也可能发生其他几种神经病变综合征。我们描述了一例在新发 1 型糖尿病患者中与糖尿病酮症酸中毒相关的多发性神经病的罕见病例。一名 42 岁的男性因糖尿病酮症酸中毒入院,伴有呼吸和肾衰竭并发症,分别需要机械通气和血液透析治疗。在糖尿病酮症酸中毒从危急状态改善后,他出现了四肢瘫痪,伴有感觉障碍和疼痛,以及右侧面瘫、左侧喉返神经麻痹和左侧舌下神经麻痹。自主神经功能也受到了损害。由于糖尿病酮症酸中毒相关多发性神经病的病理生理学、预防和治疗尚不清楚,应密切监测糖尿病酮症酸中毒患者的神经功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d908/9077735/7cc0982efd97/JDI-13-918-g002.jpg

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