© 2003 Fellowship of Postgraduate Medicine
SELF ASSESSMENT QUESTION
Neurology
An unusual cause of peripheral neuropathy in a diabetic patient on dialysis: "a sural surprise"
Department of Renal Medicine, Guys Hospital, Guys, Kings and St Thomas Medical School, London
Correspondence to:
Correspondence to:
Dr David Goldsmith, Renal Unit, Guys Hospital, London SE1 9RT, UK;
david.goldsmith@gstt.sthames.nhs.uk
Accepted 3 December 2002
Answers on p 480.
Keywords: prosthetic heart valves
| The first 150 words of the full text of this article appear below. |
Peripheral neuropathy is a common medical problem, with many potential aetiologies.1 One of the commonest systemic diseases to cause a peripheral neuropathy is diabetes mellitus.2,3 Patients with end stage renal failure are also prone to develop peripheral neuropathy, in part related to how well uraemic toxins are removed by renal replacement therapy.4
We present the case of a woman with diabetes, on dialysis treatment, who developed an acute severe peripheral neuropathy. There were unusual clinical and investigational findings that mandated further diagnostic work-up.
An overweight woman, born in Antigua in 1948, developed type II diabetes mellitus in 1979. From 1983 she required oral hypoglycaemic agents then insulin. In 1994 she developed heavy proteinuria and impaired renal function (inulin glomerular filtration rate 52 ml/min corrected for body surface area, n=125 ml/min/1.73 m2) and required retinal laser photocoagulation.
She was lost to follow up, but reappeared in 1998 no longer
Relevant Article
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An unusual cause of peripheral neuropathy in a diabetic patient on dialysis: "a sural surprise"
Postgrad. Med. J. 2003 79: 480-481.[Extract] [Full Text] [PDF]
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