RESUMO
Erythermalgia is a very rare acrosyndrome mainly characterized by lower limbs pain. It is either primitive or secondary. Concomittence of erythermalgia and diabetes is a coincidence and since the latter induces neuropathic and vascular lesions, erythermalgia is then considered as a consequence. We report the case of a young type 1 diabetic patient who presents with severe form of erythermalgia. Through this case report and a review of the literature, we shall explain the etiopathogenic mecanisms involved in erythermalgia in a diabetic patient and highlight the diagnosis and management challenges.
Assuntos
Diabetes Mellitus Tipo 1/complicações , Eritromelalgia/diagnóstico , Eritromelalgia/terapia , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , Consanguinidade , Diagnóstico Diferencial , Epilepsia/complicações , Eritromelalgia/complicações , Eritromelalgia/tratamento farmacológico , Eritromelalgia/genética , Humanos , Perna (Membro)/patologia , Masculino , Mialgia/etiologia , Fatores de Risco , Resultado do TratamentoRESUMO
BACKGROUND: Diabetic retinopathy (DR) is the most frequent microvascular complication of type I diabetes (T1D). Some well-controlled type I diabetics may develop DR, while other poorly-controlled diabetics do not develop DR. This might be explained by certain susceptibility genes or protective genes. The purpose of our study is to search for any association between the HLA class I and II markers and DR in the Algerian population. PATIENTS AND METHODS: This study was carried out in 52 T1D subjects with and without DR compared to 140 healthy controls. HLA typing was performed using the "microlymphocytotoxicity" technique. RESULTS: The frequency of HLA-A29 and HLA-DR9 antigens is higher in T1D with DR compared to T1D without DR and to controls with frequencies of HLA-A29 (59.26% vs. 0%, OR=∞, pc=4.6×10(-7)), (59.26% vs. 5.66%, OR=24.24, pc=7.6×10-10) and HLA-DR9 (29.63% vs. 0%, OR=∞, pc=1.310(-3)), (29.63% vs. 4.29%, OR=9.40, pc=7.010(-5)) respectively. However, the frequency of HLA-B49 antigen is significantly lower in T1D with DR than in T1D without DR (3.7% vs. 28%, OR=0.10, pc=8.8×10(-3)) and compared to controls (3.7% vs. 22.64%, OR=0.13, pc=0.011). CONCLUSION: HLA-A29 and HLA-DR9 antigens are probably markers of susceptibility for DR while HLA-B49 antigen is probably associated with a protective effect in the Algerian population.
Assuntos
Retinopatia Diabética/genética , Genes MHC da Classe II , Genes MHC Classe I , Antígenos HLA/genética , Adulto , Argélia/epidemiologia , Testes Imunológicos de Citotoxicidade , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/complicações , Retinopatia Diabética/sangue , Retinopatia Diabética/etnologia , Etnicidade/genética , Feminino , Predisposição Genética para Doença , Antígenos HLA-A/genética , Antígenos HLA-B/genética , Subtipos Sorológicos de HLA-DR/genética , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto JovemRESUMO
The authors report a retrospective and descriptive study, conducted in November 2005 in the service of Diabetology of Mustapha CHU (Alger). The aim was to determine the associative factors to ischemic in rest electrocardiogram by type 2 diabetic patients. The study has been turned to 262 dossiers (141 of women and 121 of men) of hospitalised patients from January 2004 to Jun 2005 in diabetological Service. 130 of patients (73 women and 5è men) have ischemia in Electrocardiogram. Their mean age was 60 years The visible ischemia in classical Electrocardiogram was correlated with arterielle blunt drug (p ≤ 0.03), dyslipidemia (p ≤ 0.01), smoking (p ≤ 0.001) and nephropathy (p ≤ 0.001). The classical Electrocardiogram can nock to point out the ischemia by important proportion of type 2 diabetic patients.
Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Isquemia Miocárdica/diagnóstico , Nefropatias Diabéticas/epidemiologia , Dislipidemias/epidemiologia , Eletrocardiografia , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/epidemiologia , Descanso , Estudos Retrospectivos , Fumar/epidemiologiaRESUMO
Les auteurs rapportent une etude retrospective et descriptive realisee en Novembre 2005; dans le service de diabetologie du Centre Hospitalier et Universitaire de Mustapha d'Alger. L'objet etait de determiner les facteurs associes a l'ischemie vue al'Electrocardiogramme de repos chez le diabetique type 2 L'etude a concerne 262 dossiers (dont 141 des femmes et 121 des hommes) des patients hospitalises dans la periode allant de Janvier 2004 a Juin 2005. Parmi ceux-ci il y a 130 patients ischemiques dont 73 femmes (56) et 57 hommes (44). L'age moyen est de 60 ans.L'ischemie visible a l'electrocardiogramme de repos est corrolee avec hypertension arterielle (p . 0;03); les dyslipidemies (p. 0;01); le tabagisme (p.0;001) et la nephropathie (p.0;001) l'Electrocardiogramme de repos peut encore aider a mettre en evidence l_fischemie chez une proportion importante de patients diabetiques type 2
