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Inflammatory Diabetic Neuropathy: Helpful Diagnostic Parameters

机译:炎症性糖尿病神经病变:有用的诊断参数

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Objectives:Mild inflammatory diabetic neuropathies (IDNs) overlap with diabetic sensorimotor neuropathy (DPN) in clinical presentation and electrophysiological and laboratory tests. This study is to determine whether BDN can be differentiated from DPN by clinical features, electrophysiological, pathological, or laboratory tests. Methods: Suspected IDN cases were identified by a subacute onset and progressive sensory or motor neuropathy in patients with diabetes. Results:IDN occurred earlier in the course of diabetes mellitus and had higher prevalence of limb weakness, walking difficulty, and more severe electrophysiological abnormalities suggesting both demyelination and axonal loss. Sensory nerve biopsies in IDN showed perivascular inflammatory infiltrates, decreased fiber density, increased demyelination, and axonal degeneration. Most patients with IDN improved with immunotherapy. Conclusions:Features that favor IDN over DPN are limb weakness, more severe nerve conduction abnormalities, inflammatory infiltrates on nerve biopsy, and a favorable response to immunotherapy. A nerve biopsy can help establish an inflammatory cause.
机译:目的:轻度炎症性糖尿病神经病(IDNS)在临床介绍和电生理学和实验室测试中与糖尿病感觉传感器神经病变(DPN)重叠。本研究是通过临床特征,电生理学,病理或实验室测试确定BDN是否可以与DPN分化。方法:通过糖尿病患者的亚急性发作和渐进式感官或运动神经病变鉴定疑似IDN病例。结果:IDN在糖尿病患过程之前发生,肢体弱点,行走困难和更严重的电生理异常的患病率更高,表明脱髓和轴突损失。 IDN中的感觉神经活检显示血管外炎症浸润,降低纤维密度,脱髓鞘增加,轴突变性。大多数患有IDN的患者改善了免疫疗法。结论:对DPN的IDN的特征是肢体的弱点,更严重的神经传导异常,神经活检的炎症性浸润,以及对免疫疗法的有利反应。神经活检可以帮助建立炎症原因。

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