Chitrala Sruthi, Butta Nikhil, Immadisetty Sandeep Kumar, Suvvari Tarun Kumar, Thomas Vimal
Department of General Medicine, Nimra Institute of Medical Sciences, Vijayawada, Andhra Pradesh, India.
Department of General Medicine, Guntur Medical College, Guntur, Andhra Pradesh, India.
Clin Med Insights Endocrinol Diabetes. 2023 Jul 27;16:11795514231189038. doi: 10.1177/11795514231189038. eCollection 2023.
Diabetes mellitus is one of the most debilitating diseases, diabetic neuropathy happens to be the most common and perhaps the most serious complication of diabetes mellitus, often leading to morbidity and mortality. A 60 year old female presented with disorientation, history of vomiting, shortness of breath, respiratory failure initially. Blood reports revealed that she was positive for ketone bodies with elevated HbA1c and general random blood sugar. Chest radiogram revealed atelectasis of the right lung with prominent involvement of right middle and lower lobes. High-resolution computed tomography of chest confirmed the findings and unilateral diaphragmatic paralysis due to phrenic nerve neuropathy due to undetected type 2 diabetes was diagnosed. Although phrenic nerve paralysis is a rare occurrence with diabetes, the possibility shouldn't be overlooked as a presentation of diabetes mellitus.
糖尿病是最使人衰弱的疾病之一,糖尿病神经病变恰好是糖尿病最常见且可能最严重的并发症,常常导致发病和死亡。一名60岁女性最初表现为定向障碍、呕吐史、呼吸急促和呼吸衰竭。血液报告显示她酮体呈阳性,糖化血红蛋白(HbA1c)升高,随机血糖普遍偏高。胸部X光片显示右肺肺不张,右中、下叶受累明显。胸部高分辨率计算机断层扫描证实了这些发现,并诊断出因未被发现的2型糖尿病导致膈神经病变引起的单侧膈肌麻痹。尽管膈神经麻痹在糖尿病中很少见,但作为糖尿病的一种表现,这种可能性不应被忽视。