Korean J Fam Med.  2019 May;40(3):194-198. 10.4082/kjfm.17.0127.

Diabetic Neuropathic Cachexia in a Young Woman

• Yusof NA
• Idris NS
• Zin FM

• KMID: 2449019
• DOI: http://doi.org/10.4082/kjfm.17.0127

Abstract

Profound weight loss with painful symmetrical peripheral neuropathy in diabetic patients was first described as diabetic neuropathic cachexia more than 4 decades ago. It is a distinct type of diabetic peripheral neuropathy that occurs in the absence of other microvascular and autonomic complications of diabetes. The mechanism and precipitating cause are unknown. It was reported to have good prognosis with spontaneous recovery within months to 2 years. However, it was frequently missed by clinicians because the profound weight loss is the most outstanding complaint, rather than the pain, numbness, or weakness. This often leads to extensive investigation to exclude more sinister causes of weight loss, particularly malignancy. We report a case of a young woman with well-controlled diabetes who presented with profound unintentional weight loss (26 kg), symmetrical debilitating thigh pain, and clinical signs of peripheral neuropathy. As the disease entity may mimic an inflammatory demyelinating cause of neuropathy, she was treated with a trial of intravenous immunoglobulin, which failed to give any significant benefit. However, she recovered after 6 months without any specific treatment, other than an antidepressant for the neuropathic pain and ongoing rehabilitation.

Keyword

Peripheral Nervous System Diseases; Diabetic Neuropathies; Cachexia; Weight Loss

MeSH Terms

Cachexia*
Diabetic Neuropathies
Female
Humans
Hypesthesia
Immunoglobulins
Neuralgia
Peripheral Nervous System Diseases
Prognosis
Rehabilitation
Thigh
Weight Loss
Immunoglobulins