Vallés GAS, Velázquez CW, Osorio SCM

Language: Spanish
References: 13
Page: 101-109
PDF size: 161.06 Kb.

ABSTRACT

The objective of this paper was to describe the case of a female who suffered type 1 diabetes mellitus and Charcot neuroarthropathy, the first of this type managed in "Guillermo Dominguez Lopez" general university hospital in Las Tunas province in 2013. This patient was a 21 years-old Caucasian woman, who went to the angiology and vascular surgery service of the hospital, because she presented with Charcot neuropathic arthropathy at Eichenholtz´s stage III in the course of type 1 of diabetes mellitus of 12 years of evolution and inadequate metabolic control. This was a rare and uncommon complication in our setting. The patient was questioned about her symptoms and physically examined, then subjected to analytical and imaging studies; it was finally decided to admit her to hospital. In her first period of hospitalization, diabetes and blood hypertension were duly controlled and the foot swelling was reduced. After several admissions to hospital due to urinary sepsis and lack of metabolic control, she was accepted in the hemodyalisis treatment program due to renal failure, but later on, she began suffering uremic pericarditis, heart failure and finally died. In the face of raised volume, foot edema, painless joint injure, joint deformity and instability with sensory-motor neuropathy in lower limbs, one should think of Charcot neuroarthropathy and thus prevent the evolution into the last Eichenholtz´s stage. This is a case of great interest for the medical care of diabetic patients by all medical specialties and mainly aimed at the primary health care.

REFERENCES

1. Schinca N, Álvarez J. Artropatía neuropática o pie de Charcot. Traumatol Biomedicina. 2012;7(1):44-50.

2. Frykberg GR, Armstrong GD, Giurini J, Edward A, Kravettle M, Kravitz S, et al. Diabetic foot disorders. A clinical practice guideline: for the American collage of foot and ankle surgeons and the American collage of foot and ankle orthopedic and medicine. Am Acad Orthop Surg. 2000;39(5):1-60.

3. García Herrera AL, Fernández Montequín JI, Rodríguez Fernández R. El Pie Diabético. Madrid: Elsevier; 2004.

4. Marrero-Riverón L, Rondón-García O, Silverio-Cabrera A, Rodríguez-Román D. Articulación neuropática de Charcot en un niño. Rev Cubana de Orthop y Traumatol. 2013 [citado 11 Feb 2014];27(2). Disponible en: http://www.revortopedia.sld.cu/index.php/revortopedia/article/view/7

5. Sommer T, Lee T. Charcot foot: the diagnostic dilemma. Am Fam Phy. 2001;64:1591-7.

6. Rajbhandri S, Jenkins R, Daries C, Tesfafe S. Charcot neuro-arthropathy in diabetes mellitus. Diabetol. 2002;45:1085-96.

7. Pinzur MS. Current Concepts Review: Charcot arthropathy of the foot and ankle. Foot Ankle Int. 2007;28(8):952-9.

8. Van der Ven A, Chapman CB, Bowker JH. Charcot neuro-arthropathy of the foot and ankle. J Am Acad Orthop Surg. 2009;17(9):562-71.

9. Llanes Barrios JA, Fernández Montequín JI, Seuc Jo HA, Álvarez Duarte TH, Chirino Carreño N, Valdés Pérez C, et al. Utilidad del Michigan Neuropathy Program para identificar clínica de neuropatía diabética y evaluar su severidad. Angiología. 2008 [citado 1 Ene 2009];9(1):1-5. Disponible en: http://bvs.sld.cu/revistas/ang/vol9_1_08/ang16104.htm

10. Pinilla Análida E, Barrera M del P, Sánchez Ana L, Mejía A. Factores de riesgo en diabetes mellitus y pie diabético: un enfoque hacia la prevención primaria. Rev Colomb Cardiol. 2013;20(4):213-22.

11. Molina M, García Jodar J, Aliaga R, Ampudia-Blasco FJ, Real JT, Carmena R, et al. Diagnóstico diferencial entre osteomielitis de pie y artropatía de Charcot aguda. Av Diabetol. 2009;25:163-4.

12. Llanes Barrios JA, Álvarez Duarte HT, Toledo Fernández AM, Fernández Montequín JI, Torres OF, et al. Manual para la prevención, diagnóstico y tratamiento del pie diabético. Rev Cubana de Angiol Cir Vasc. 2009 [citado 12 Feb 2014];10(1):42-96. Disponible en: http://bvs.sld.cu/revistas/ang/vol10_01_11/ang08111.htm

13. Awad A, Chandan G.R, Kimberly K.A, Robert J.S. Charcot Arthropathy of the Shoulder Associated with Typical and Atypical Findings. Clin Anatomy. 2012 [cited 2012 Jun 13]. Available from: http://onlinelibrary.wiley.com/doi/10.1002/ca.22110/