Subject(s)
Lymphoma, B-Cell/complications , Muscular Atrophy/etiology , Neuromuscular Diseases/pathology , Peripheral Nerves/pathology , Retroperitoneal Neoplasms/complications , B-Lymphocytes/pathology , Biomarkers, Tumor/analysis , Biopsy , Bone Marrow Examination , Diagnosis, Differential , Electromyography , Humans , Leg/innervation , Lymphoma, B-Cell/diagnosis , Lymphoma, B-Cell/pathology , Male , Middle Aged , Muscular Atrophy/diagnosis , Muscular Atrophy/pathology , Nerve Degeneration , Neuromuscular Diseases/diagnosis , Neuromuscular Diseases/etiology , Peripheral Nervous System Diseases/diagnosis , Retroperitoneal Neoplasms/diagnosis , Retroperitoneal Neoplasms/pathology , Sciatica/etiology , Weight LossABSTRACT
Proximal diabetic neuropathy is a disabling neuropathy that occurs predominantly in non-insulin-dependent diabetic patients over the age of 50. Inflammatory lesions have been found in nerve biopsy specimens of diabetic patients with severe proximal neuropathy or with other patterns of multifocal neuropathy. Some of these patients respond dramatically to treatment with corticosteroids or with other immunomodulators. In this article we report on our findings in 4 additional patients with painful proximal diabetic neuropathy and different patterns of inflammatory nerve lesions whose condition improved spontaneously shortly after performance of a nerve biopsy, without additional treatment.
Subject(s)
Diabetic Neuropathies/pathology , Diabetic Neuropathies/physiopathology , Neuritis/pathology , Neuritis/physiopathology , Aged , Biopsy , Diabetes Mellitus, Type 2 , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pain , Postoperative Period , Remission, SpontaneousABSTRACT
A 20-year-old man developed over three weeks a sensory and painful neuropathy associated with diffuse alopecia. There was motor weakness, and superficial and deep hypoesthesia of the inferior limbs. Deep tendon reflexes were normal. Electrophysiological study mainly showed axonal motor neuropathy. This patient was admitted six weeks after the first symptoms. The clinical picture suggested thallium poisoning, which was confirmed by thallium concentrations in plasma, urine, hair and nails. After search, thallium was identified in a rat poison.