Diabetic Myonecrosis: An Indian Experience

Meher, Dayanidhi; Mathew, Vivek; Misgar, Raiz Ahmed; Mukherjee, Satinath; Chowdhury, Subhankar; Chowdhury, Jyothi

doi:10.2337/diaclin.31.2.53

Cited by 6 publications

(3 citation statements)

References 22 publications

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“…With resolution, the recurrence rate is approximately 40%. The long-term outcome tends to be poor due to five-year mortality from superimposed diabetic complications [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

A Rare and Unique Complication of Uncontrolled Type 2 Diabetes Mellitus: A Case Report and Literature Review of Spontaneous Diabetic Myonecrosis

Johnson¹,

Oo²,

Oo³

et al. 2023

Cureus

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There are many microvascular and macrovascular complications regarding uncontrolled diabetes mellitus (DM). Among them, diabetes myonecrosis is one of the complications but rarely seen in the uncontrolled DM patient population. Here, we present a rare case of DM myonecrosis in a patient with elevated hemoglobin A1c (HbA1c) of 18.2% and discuss the literature review of diabetes myonecrosis. A 48-year-old male with hypertension and uncontrolled type 2 diabetes mellitus (T2DM) with hemoglobin A1c of 18.2% presented with progressive swelling and pain in the right thigh for two days. Physical examination demonstrated swollen and tense tender right thigh with a circumference five inches larger than the left. Computed tomography (CT) and magnetic resonance imaging (MRI) results revealed severe myositis of the right leg, likely myonecrosis, and associated fascial edema/fasciitis. The patient was also complicated with diffuse anasarca, which was corrected with albumin transfusion and furosemide. Aspirin and lisinopril were also started for antithrombotic and cardioprotective effects. The right thigh swelling improved, and the patient could ambulate with supportive measures and regular physical therapy (PT). He was discharged home after 45 days of hospitalization. Diabetic myonecrosis is a rare condition and hence is underdiagnosed. In patients with uncontrolled diabetes, especially with diabetic complications, physicians should have high clinical suspicion to diagnose diabetic myonecrosis when patients present with an acute unilateral painful swollen limb. Our case highlights the complicated course of diabetes myonecrosis with anasarca, improved with supportive measures.

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“…With resolution, the recurrence rate is approximately 40%. The long-term outcome tends to be poor due to five-year mortality from superimposed diabetic complications [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

A Rare and Unique Complication of Uncontrolled Type 2 Diabetes Mellitus: A Case Report and Literature Review of Spontaneous Diabetic Myonecrosis

Johnson¹,

Oo²,

Oo³

et al. 2023

Cureus

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“…In another series by Gupta et al from an Indian centre, the mean (SD) age reported was 45.5 (7.3) years, the mean duration of diabetes was 9 years with an equal distribution of men and women and the mean (SD) HbA1c, 9.5% (0.6%) indicated poor glycaemic control at presentation with all the patients having concomitant one or more microvascular complications (Table II). [4][5][6][7] It being a rare disorder, the pathophysiology of this entity is unclear. Various hypotheses have postulated a complex interplay of atherosclerosis, microangiopathy, coagulopathy and ischaemia reperfusion injury.…”

Section: Discussionmentioning

confidence: 99%

Diabetic myonecrosis in end-stage renal disease

Naredi

Adhikari

Bhardwaj

et al. 2022

NMJI

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Diabetic myonecrosis or muscle infarction (DMI), a clinicoradiological entity is an underdiagnosed complication of diabetes mellitus. It refers to spontaneous aseptic necrosis of skeletal muscles commonly of the lower limb without evidence of any large vessel disease. It presents as painful swollen limb without any external insult in patients with long-standing diabetes mellitus with other microvascular complications especially nephropathy. We present four instances of DMI in our patients who had end-stage renal disease with a varied course.

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“…1 resulting due to spontaneous ischemic necrosis of skeletal muscles. 2 It is one of the micro and macro-vascular complications of chronic diabetes mellitus.…”

Section: Introductionmentioning

confidence: 99%

Diabetes Induced Bilateral Upper Limb Myonecrosis, an Unusual Complication of Chronic Type 2 Diabetes Mellitus : A Case Report

Walke¹,

Sawardekar²,

Nene³

et al. 2015

jemds

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Diabetic myonecrosis, one of the complications of chronic, inadequately controlled diabetes mellitus is seen more commonly in lower extremities and in females. We report a case of diabetic myonecrosis in upper extremities, an underreported complication of diabetes in a male from a tertiary care hospital in Mumbai. Diabetic myonecrosis usually responds to conservative management, but the long-term prognosis of the condition is poor. Identification and correct diagnosis of diabetic myonecrosis is important to avoid wrong treatment which could result in unnecessary complications.

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Diabetic Myonecrosis: An Indian Experience

Abstract: IN BRIEF Diabetic myonecrosis is an uncommon muscular complication of diabetes with significant morbidity. Clinical features and radiological findings are helpful in the diagnosis of myonecrosis. Management is conservative and focused on symptomatic relief and control of diabetes.

Cited by 6 publications

References 22 publications

A Rare and Unique Complication of Uncontrolled Type 2 Diabetes Mellitus: A Case Report and Literature Review of Spontaneous Diabetic Myonecrosis

A Rare and Unique Complication of Uncontrolled Type 2 Diabetes Mellitus: A Case Report and Literature Review of Spontaneous Diabetic Myonecrosis

Diabetic myonecrosis in end-stage renal disease

Diabetes Induced Bilateral Upper Limb Myonecrosis, an Unusual Complication of Chronic Type 2 Diabetes Mellitus : A Case Report

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