Journal List > J Korean Diabetes > v.16(1) > 1055002

Min, Jo, Choi, Choi, Park, Jung, Kang, Lee, Yang, and Yoon: Diabetic Neuropathic Cachexia in a 50-Year-Old Woman with Type 2 Diabetes: First Case Report in Korea

Abstract

Diabetic neuropathic cachexia (DNC) is one of the rarest presentations of diabetic neuropathy associated with profound weight loss. A 50-year-old Korean woman with poorly controlled type 2 diabetes complained of intractable pain in the trunk and lower extremities, and total body weight loss of 17% over a 6 month period. The patient's symptoms persisted after glucose control and various medications for neuropathic pain. A diagnosis of DNC was made based on the rapid onset of severe pain, polyneuropathy, and marked weight loss without evidence of end organ disease other than mild retinopathy, and the exclusion of other possible causes. Spontaneous improvement of the patient's neuropathic pain and gradual weight gain occurred after 6 months of supportive care. Since the original report of DNC, 31 cases have been published in the English-language literature; however, ours is the first reported case in Korea. Clinicians must be aware of this debilitating complication of diabetes because of its severity and rapid progression.

References

1. Ellenberg M. Diabetic neuropathic cachexia. Diabetes. 1974; 23:418–23.
crossref
2. Naccache DD, Nseir WB, Herskovitz MZ, Khamaisi MH. Diabetic neuropathic cachexia: a case report. J Med Case Rep. 2014; 8:20.
crossref
3. Weintrob N, Josefsberg Z, Galazer A, Vardi P, Karp M. Acute painful neuropathic cachexia in a young type I diabetic woman. A case report. Diabetes Care. 1997; 20:290–1.
crossref
4. Deorchis VS, Herskovitz S, Laureta E, Heptulla RA. Neuropathic cachexia associated with type 1 diabetes in an adolescent girl. Pediatr Neurol. 2013; 49:282–5.
crossref
5. Jackson CE, Barohn RJ. Diabetic neuropathic cachexia: report of a recurrent case. J Neurol Neurosurg Psychiatry. 1998; 64:785–7.
crossref
6. Chandler PT, Singh RS, Schwetschenau RP. Diabetic neuropathic cachexia. Acta Diabetol Lat. 1978; 15:212–6.
crossref
7. Blau RH. Diabetic neuropathic cachexia. Report of a woman with this syndrome and review of the literature. Arch Intern Med. 1983; 143:2011–2.
crossref
8. D'Costa DF, Price DE, Burden AC. Diabetic neuropathic cachexia associated with malabsorption. Diabet Med. 1992; 9:203–5.
9. Archer AG, Watkins PJ, Thomas PK, Sharma AK, Payan J. The natural history of acute painful neuropathy in diabetes mellitus. J Neurol Neurosurg Psychiatry. 1983; 46:491–9.
crossref
10. Godil A, Berriman D, Knapik S, Norman M, Godil F, Firek AF. Diabetic neuropathic cachexia. West J Med. 1996; 165:382–5.
11. Neal JM. Diabetic neuropathic cachexia: a rare manifestation of diabetic neuropathy. South Med J. 2009; 102:327–9.
crossref
12. Grewal J, Bril V, Lewis GF, Perkins BA. Objective evidence for the reversibility of nerve injury in diabetic neuropathic cachexia. Diabetes Care. 2006; 29:473–4.
crossref
13. Yuen KC, Day JL, Flannagan DW, Rayman G. Diabetic neuropathic cachexia and acute bilateral cataract formation following rapid glycaemic control in a newly diagnosed type 1 diabetic patient. Diabet Med. 2001; 18:854–7.
crossref
14. Kihara M, Zollman PJ, Smithson IL, Lagerlund TD, Low PA. Hypoxic effect of exogenous insulin on normal and diabetic peripheral nerve. Am J Physiol. 1994; 266:E980–5.
crossref
15. Tesfaye S, Malik R, Harris N, Jakubowski JJ, Mody C, Rennie IG, Ward JD. Arteriovenous shunting and proliferating new vessels in acute painful neuropathy of rapid glycaemic control (insulin neuritis). Diabetologia. 1996; 39:329–35.
crossref
16. Jain R, Jain S, Raison CL, Maletic V. Painful diabetic neuropathy is more than pain alone: examining the role of anxiety and depression as mediators and complicators. Curr Diab Rep. 2011; 11:275–84.
crossref

TOOLS
Similar articles