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糖尿病中罕见的肌肉并发症:一例糖尿病性肌肉梗死病例报告

Uncommon Muscle Complications in Diabetes: A Case Report on Diabetic Muscle Infarction.

作者信息

Pawar Twinkle, Malde Sunny, Gupta Sushrut, Jeyachandran Vijay, Kashiv Pranjal, Dubey Shubham, Sejpal Kapil N, Balwani Manish, Pasari Amit S, Bawankule Charulata P

机构信息

Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.

Nephrology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.

出版信息

Cureus. 2024 Sep 7;16(9):e68874. doi: 10.7759/cureus.68874. eCollection 2024 Sep.

Abstract

Diabetic muscle infarction (DMI) is a rare but severe complication of diabetes mellitus (DM), characterised by acute muscle pain and swelling, primarily in the lower extremities. Prompt recognition and management are critical for preventing further complications. We report the case of a 54-year-old male with a long-standing history of type 2 DM and hypertension. The patient presented with acute, severe pain in the left calf, which had progressively worsened over several days. Physical examination revealed oedema and tenderness in the left calf. Laboratory investigations indicated muscle injury and inflammation, and MRI confirmed the diagnosis of DMI by showing areas of muscle inflammation. The patient was treated with hemodialysis, dual antiplatelet, and supportive care, including analgesics for pain management and stringent blood glucose control. He was advised to avoid excessive physical activity and was educated on the importance of medication adherence and lifestyle modifications. Regular follow-up was scheduled to monitor his progress and adjust the treatment plan as necessary. This case underscores the importance of considering DMI in patients with diabetes presenting with acute muscle pain. Early diagnosis and appropriate management are essential for preventing complications and improving patient outcomes. Clinicians should maintain a high index of suspicion for DMI to ensure timely and effective intervention.

摘要

糖尿病性肌肉梗死(DMI)是糖尿病(DM)一种罕见但严重的并发症,其特征为急性肌肉疼痛和肿胀,主要发生在下肢。及时识别和处理对于预防进一步并发症至关重要。我们报告一例54岁男性患者,有2型糖尿病和高血压的长期病史。患者出现左小腿急性剧痛,数天来逐渐加重。体格检查发现左小腿水肿和压痛。实验室检查提示肌肉损伤和炎症,磁共振成像(MRI)通过显示肌肉炎症区域确诊为DMI。患者接受了血液透析、双联抗血小板治疗及支持治疗,包括使用镇痛药控制疼痛和严格控制血糖。建议患者避免过度体力活动,并就坚持用药和改变生活方式的重要性进行了教育。安排定期随访以监测其病情进展,并根据需要调整治疗方案。该病例强调了在出现急性肌肉疼痛的糖尿病患者中考虑DMI的重要性。早期诊断和适当处理对于预防并发症和改善患者预后至关重要。临床医生应高度怀疑DMI以确保及时有效的干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1168/11459590/993fbd59c993/cureus-0016-00000068874-i01.jpg

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