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Shimizu Y, Kozawa J, Hayakawa T, Sakai Y, Kimura T, Kitamura T, Murase S, Tanaka H, Maeda N, Otsuki M, Matsuoka T, Mochizuki H, Iwahashi H, Shimomura I. Asymptomatic Pontine Lesion and Diabetic Amyotrophy after Rapid Improvement of Poor Glycemic Control in a Patient with Type 1 Diabetes. Intern Med 2019; 58:3433-3439. [PMID: 31391398 PMCID: PMC6928506 DOI: 10.2169/internalmedicine.2835-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
We herein report a 28-year-old woman with type 1 diabetes with an asymptomatic pontine lesion and diabetic amyotrophy. She had suffered from diabetes from 10 years old. Treatment in a hospital reduced the hemoglobin A1c level from 14.2% to 7.2% for approximately 2 months. She suffered from acute-onset pain and weakness of the lower limb muscles without central nervous system manifestations. Magnetic resonance imaging showed high-intensity lesions at the brainstem and lower limb muscles on T2-weighted images. These findings and symptoms gradually resolved. Rapid treatment of poor glycemic control might increase the risk of asymptomatic pontine lesions and diabetic amyotrophy.
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Affiliation(s)
- Yuri Shimizu
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Japan
| | - Junji Kozawa
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Japan
| | - Tomoaki Hayakawa
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Japan
| | - Yasuha Sakai
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Japan
| | - Takekazu Kimura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Japan
| | - Tetsuhiro Kitamura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Japan
| | - Sho Murase
- Department of Neurology, Graduate School of Medicine, Osaka University, Japan
| | - Hisashi Tanaka
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka University, Japan
| | - Norikazu Maeda
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Japan
- Department of Metabolism and Atherosclerosis, Graduate School of Medicine, Osaka University, Japan
| | - Michio Otsuki
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Japan
| | - Takaaki Matsuoka
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Japan
| | - Hideki Mochizuki
- Department of Neurology, Graduate School of Medicine, Osaka University, Japan
| | - Hiromi Iwahashi
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Japan
- Department of Diabetes Care Medicine, Graduate School of Medicine, Osaka University, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Japan
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