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Phrenic neuropathy in association with diabetes.
J E White1, R E Bullock, P Hudgson
1Department of Respiratory Medicine, Freeman Hospital, Newcastle upon Tyne, England.
Diabetic Medicine : a Journal of the British Diabetic Association
|December 1, 1992
Summary
Bilateral diaphragmatic paralysis from phrenic neuropathy, a rare complication of Type 2 diabetes, caused a 51-year-old man's breathlessness. This highlights the need to assess diaphragmatic function in unexplained shortness of breath.
Area of Science:
- Neurology
- Pulmonology
- Endocrinology
Background:
- Type 2 diabetes mellitus is a common metabolic disorder associated with various complications.
- Diaphragmatic dysfunction can lead to significant respiratory symptoms, including exertional dyspnea and orthopnea.
- Phrenic neuropathy, affecting the nerve that controls the diaphragm, is a recognized but uncommon neurological complication.
Observation:
- A 51-year-old male with a history of Type 2 diabetes presented with progressive exertional dyspnea and orthopnea.
- Clinical evaluation revealed bilateral diaphragmatic paralysis.
- Diagnostic workup excluded other causes of neuropathy and microvascular disease.
Findings:
- The patient's symptoms were attributed to bilateral phrenic neuropathy.
- Phrenic neuropathy was identified as a potential, albeit rare, complication of long-standing Type 2 diabetes mellitus.
- No other peripheral neuropathy or diabetic microvascular complications were evident.
Implications:
- Phrenic neuropathy should be considered in the differential diagnosis of unexplained dyspnea and orthopnea, particularly in diabetic patients.
- Assessment of diaphragmatic function may be crucial for patients with unexplained respiratory symptoms and diabetes.
- This case underscores the diverse and sometimes unexpected manifestations of diabetic complications.