He Jinwen, Wang Liyan, Robertson Thomas, Rangaswamaiah Swetha, Malabu Usman H
Department of Diabetes and Endocrinology Townsville University Hospital, Townsville, Australia.
Department of Anatomical Pathology Royal Brisbane and Women's Hospital, Herston, Australia.
Case Rep Endocrinol. 2024 Sep 27;2024:8839798. doi: 10.1155/2024/8839798. eCollection 2024.
A 24-year-old Indigenous Australian female with long-standing, poorly controlled type 1 diabetes mellitus (T1DM) presented with 3 months' history of unilateral thigh swelling and pain. Her laboratory investigations showed evidence of a persistent inflammatory state with normal creatine kinase. Infectious and autoimmune investigations were negative. Imaging demonstrated evidence of muscular oedema and atrophy. Muscular pain and swelling have a broad list of differential diagnoses. This case highlights a rare but potentially debilitating complication of diabetes mellitus-diabetic myonecrosis with its challenges in reaching a definitive diagnosis due to non-specific symptomology and laboratory findings. However, it is an important differential of leg pain and swelling to consider, particularly in those with long-standing diabetes and pre-existing microvascular complications. Glycaemic control is paramount in preventing this potentially severe diabetic complication.
一名24岁的澳大利亚原住民女性，患有长期控制不佳的1型糖尿病（T1DM），出现单侧大腿肿胀和疼痛3个月。她的实验室检查显示存在持续炎症状态，肌酸激酶正常。感染性和自身免疫性检查均为阴性。影像学检查显示有肌肉水肿和萎缩的迹象。肌肉疼痛和肿胀有众多鉴别诊断。本病例突出了糖尿病一种罕见但可能使人衰弱的并发症——糖尿病性肌坏死，由于症状和实验室检查结果不具特异性，在明确诊断方面存在挑战。然而，它是腿痛和肿胀需要考虑的重要鉴别诊断，尤其是在患有长期糖尿病和已有微血管并发症的患者中。血糖控制对于预防这种潜在的严重糖尿病并发症至关重要。
