Stewart J D, McKelvey R, Durcan L, Carpenter S, Karpati G
Department of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, Quebec, Canada.
J Neurol Sci. 1996 Oct;142(1-2):59-64. doi: 10.1016/0022-510x(96)00126-8.
Seven diabetic patients developed a progressive, moderately severe, motor rather than sensory neuropathy predominantly affecting the legs. This met clinical and electrophysiological criteria for chronic inflammatory demyelinating polyneuropathy (CIDP). Nerve biopsies showed a variety of abnormalities, none of which clearly distinguished between diabetic polyneuropathy and CIDP. The patients were treated with combinations of corticosteroids, azathioprine, plasmapheresis and intravenous immune globulin; all improved substantially. We believe that CIDP may masquerade as unusually severe and progressive diabetic distal symmetric polyneuropathy. It is important to recognize CIDP in diabetics because, unlike diabetic polyneuropathy, CIDP is treatable.
7名糖尿病患者出现了一种进行性、中度严重的运动性而非感觉性神经病变,主要累及腿部。这符合慢性炎症性脱髓鞘性多发性神经病变(CIDP)的临床和电生理标准。神经活检显示出多种异常,但没有一种能明确区分糖尿病性多发性神经病变和CIDP。这些患者接受了皮质类固醇、硫唑嘌呤、血浆置换和静脉注射免疫球蛋白的联合治疗;所有患者均有显著改善。我们认为,CIDP可能伪装成异常严重且进行性的糖尿病远端对称性多发性神经病变。认识到糖尿病患者中的CIDP很重要,因为与糖尿病性多发性神经病变不同,CIDP是可治疗的。