Hemichorea in a patient with diabetic ketoacidosis

Yassin, Ahmed; Shroff, Sheetal; Patel, Shreshta D.; Paker, Asif M.; Berman, Megan A.; Jackson, George R.

doi:10.1016/j.jns.2014.04.038

Cited by 15 publications

(18 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The overall findings showed that T2D was increased in patients diagnosed with any of 27 AIds, and chorea minor (SIR 8.00, 95% CI 3.81–14.77) and lupoid hepatitis (5.75, 95% CI 4.46–7.29) showed the highest risks. We found no related data on lupoid (autoimmune) hepatitis but chorea minor and hemichorea have been described as a common presenting feature of metabolic disorders, including nonketotic hyperglycemia in T2D patients 26 . T2D was also increased in patients with common AIds, such as psoriasis (2.03, 95% CI 1.96–2.10), rheumatoid arthritis (1.50, 95% CI 1.44–1.57), Graves/hyperthyroidism (1.47, 95% CI 1.41–1.54), Hashimoto/hypothyroidism (2.01, 95% CI 1.92–2.10), and ulcerative colitis (1.73, 95% CI 1.64–1.82).…”

Section: Discussionmentioning

confidence: 60%

Subsequent Type 2 Diabetes in Patients with Autoimmune Disease

Hemminki

Liu

Försti

et al. 2015

Sci Rep

View full text Add to dashboard Cite

Immunological data show that type 2 diabetes (T2D) manifests autoimmune features. We wanted to test the association epidemiologically by assessing subsequent diagnosis of T2D following diagnosis of autoimmune disease (AId) and subsequent AId after T2D in the same individuals. Patients were identified from three Swedish health databases. A total of 32 different AId were included. Standardized incidence ratios (SIRs) were calculated for T2D diagnosis in patients with previously diagnosed AId and compared to those without a previous AId. Among a total of 757,368 AId patients, 15,103 were diagnosed with T2D, giving an overall SIR for T2D of 1.66. T2D risks were increased after 27 AIds; the highest SIRs were noted for chorea minor (8.00), lupoid hepatitis (5.75), and Addison disease (2.63). T2D was increased after 27 of 32 AIds but we were unable to control for factors such as obesity and smoking. However, the clearly increased risks for T2D in most types of AId patients, and in reverse order increased risks for AId after T2D, do not support an overall confounding by life-style factors. Mechanistic links shared by T2D, AId and life-style factors such as obesity, perhaps through chronic inflammation, may drive autoimmune activation of T2D and many AIds.

show abstract

Section: Discussionmentioning

confidence: 60%

Subsequent Type 2 Diabetes in Patients with Autoimmune Disease

Hemminki

Liu

Försti

et al. 2015

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Diabetic ketoacidosis ( DKA ) is the most common hyper-glycemic emergency in patients with diabetes, and it was caused by too much ketones [1][2][3][4][5][6][7]. Among the total ketone body, D-3-hydroxybutyric acid ( D-3-HB ) is the major, nearly 78% [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

RETRACTED: A highly selective OFF-ON fluorescent sensor for D-3-HB in aqueous solution and living cells

Guo

Chen

et al. 2016

Sensors and Actuators B: Chemical

View full text Add to dashboard Cite

“…In 2017, the aetiology and pathophysiology of hyperglycaemic chorea are still unknown [3,5] . However, it is more frequently seen in patients with longstanding, poorly controlled type 2 diabetes mellitus but has also been reported in type 1 diabetes or as an initial presentation of diabetes [1] .…”

Section: Discussionmentioning

confidence: 99%

“…Chorea is a hyperkinetic movement disorder caused by basal ganglia lesions [1] . Hyperglycaemic states are a rare cause and frequently misdiagnosed [1] .…”

Section: Introductionmentioning

confidence: 99%

Hyperglycaemic Hemichorea

Marques

Monteiro

Nunes

et al. 2018

European Journal of Case Reports in Internal Medicine

View full text Add to dashboard Cite

BackgroundHyperkinetic disorders such as hemichorea can be caused by cerebrovascular, infectious or inflammatory diseases or by metabolic conditions such as hyperglycaemia. Hyperglycaemic hemichorea is a rare movement disorder which is frequently misdiagnosed. It is characterized by involuntary, continuous, non-patterned movements on one side of the body, basal ganglia lesions seen on head CT or MRI, and clinical improvement after blood glucose normalization. We describe the case of a female patient with uncontrolled diabetes who presented with hemichorea.Case presentationWe report the case of a 69-year-old woman with type 2 diabetes who presented with abnormal movements of the right upper limb. She had no neurological signs other than hemichorea. Her blood glucose level was 349 mg/dl and her glycosylated haemoglobin level (HbA1c) was 10.5%. Head CT and MRI showed no changes in the basal ganglia or ischaemic lesions. The patient was started on insulin and haloperidol with clinical improvement.ConclusionLarger case series are needed to establish better understanding of the physiopathological mechanisms and diagnostic criteria of hyperglycaemic hemichorea. The most important diagnostic criterion is clinical improvement after glycaemic control.LEARNING POINTSHyperglycaemia is a rare cause of hemichorea.Better understanding of the physiopathology and the establishment of diagnostic criteria are required.Correction of the underlying hyperglycaemia will lead to rapid improvement of the movements and is the most important feature for diagnosis.

show abstract

Hemichorea in a patient with diabetic ketoacidosis

Cited by 15 publications

References 17 publications

Subsequent Type 2 Diabetes in Patients with Autoimmune Disease

Subsequent Type 2 Diabetes in Patients with Autoimmune Disease

RETRACTED: A highly selective OFF-ON fluorescent sensor for D-3-HB in aqueous solution and living cells

Hyperglycaemic Hemichorea

Contact Info

Product

Resources

About