scholarly journals A case report of palmar xanthoma with xanthomatous neuropathy

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110349
Author(s):  
Hyun Yi Lee ◽  
Dae Won Koo ◽  
Joong Sun Lee

Xanthomas are plaques or nodules consisting of an accumulation of excess lipids, resulting in the formation of foam cells in the skin or tendons. Typically, xanthomas are not accompanied by other symptoms. Here, we report a patient with a presentation of painful palmar xanthomas and subsequent diagnosis of metabolic and cardiovascular morbidities. A 44-year-old man presented with multiple yellowish, firm, and painful nodules on his right palm and fingers. Lipid panel and medical examination revealed a diagnosis of type III hyperlipoproteinemia and diabetes mellitus type II. Histopathological examination of the lesions revealed numerous lipid-laden foamy cells surrounding the nerve bundles through the dermis. This unique presentation of painful xanthomas prior to the manifestation of more significant underlying conditions suggested that xanthomas might be used as early diagnostic indicators. Based on this case, we propose more thorough examinations of palmar xanthomas in patients for earlier detection of potentially lethal diseases.

2016 ◽  
Vol 22 (2) ◽  
pp. 201625
Author(s):  
Oleksandra Marynchak ◽  
Oleksandra Pryshliak ◽  
Oksana Kopchak ◽  
Iryna Hrynchyshyn ◽  
Ludmyla Byderkevych

The main indicators of quality of life in patients with chronic hepatitis C with concomitant diabetes mellitus type II were studied on the basis of SF-36. A sharp decrease in physical and mental health was observed in patients with combined comorbidity in comparison with the group of patients without concomitant diabetes mellitus type II. Improvement of the patients’ quality of life by all parameters was detected under the influence of alpha-lipoic acid and lactulose use in addition to antiviral therapy.


Author(s):  
Kunal Lala ◽  
Viren Bhati ◽  
Divya Lala ◽  
Smita Patil

Background: The acute metabolic complications of diabetes consist of diabetic ketoacidosis (DKA), hyperosmolar non-ketotic coma (HNC), lactic acidosis (LA), and hypoglycemia. All of these are associated with significant morbidity and mortality. These can easily be prevented by early recognition and prompt management. Therefore, this study was conducted to assess the clinicopathological spectrum of acute complications of diabetes mellitus type II.Methods: This observational, analytical study was conducted on 100 patients aged more than 18 years admitted in the ICU with acute complication of Diabetes mellitus Type II. Medical history was recorded. Physical examination and investigations were done and recorded.Results: The mean age of the study population was 55.26±13.13 years. Hypoglycemia was more common (63%) than DKA (37%). Fever and sweating had the overall highest incidence (and were more in patients with hypoglycemia) while stupor, nausea and abdominal pain had the lowest incidence (and were more in patients with DKA). On examination, only one patient of DKA was drowsy. Mean temperature, pulse and respiratory rate were higher in the patients having DKA while blood pressure was higher in patients having hypoglycemia.Conclusions: It can be effectively concluded from the present study that DKA and hypoglycaemia have a broad spectrum of clinicopathological features. But the incidences vary widely. This may help in early recognition of the impending complication and thereby enabling prompt management of the same, reducing the associated morbidity and mortality.  


2020 ◽  
Vol 1 ◽  
pp. 27-34 ◽  
Author(s):  
Aleksey Oparin ◽  
Anton Kudriavtsev ◽  
Anatoliy Oparin

Diabetes mellitus is one of the most serious problems of the clinical medicine. This is determined by the fact that it is followed by multisystemic affects, as well as complications on the side of other organs and systems, among which a special place is occupied by gastroesophageal reflux disease. As for the combination and mutual influence of diabetes mellitus and gastroesophageal reflux disease, this issue has not been studied yet, the data of modern literature are not complete and quite contradictory. The aim of the study: to investigate the state of the factors of aggression and protection of the oesophageal mucosa in patients with diabetes mellitus type II with concomitant gastroesophageal reflux disease without associated pathology. Method. There were two groups of patients under observation. The first group included 45 patients with diabetes mellitus type II with concomitant gastroesophageal reflux disease (26 men and 19 women). The second group included 38 patients with gastroesophageal reflux disease without associated pathology – 20 men and 18 women. By sex, age, body weight, Helicobacter pylori infection, smoking and alcohol consumption, both groups were comparable. The surveillance program included determining the compensation ratio of carbohydrate metabolism and the state of the factor. The antioxidant protection factor was assessed by the level of catalase activity in the blood serum, as well as by the diameter of the celiac trunk and the blood flow velocity in it. Statistical processing of the obtained data was carried out with the aid of the program WINDOWS STATISTIKA 6.0. For all types of analysis, differences were considered statistically significant with p<0.05. Results. During the study, we found that in patients with diabetes mellitus type II with concomitant gastroesophageal reflux disease, as well as in patients with gastroesophageal reflux disease without associated pathology, the level of pH-metry was reduced, but with varying measures of confidence. At the same time, we found that patients with GERD without associated pathology had a decrease in the blood flow velocity in the celiac trunk. Concurrently, we ascertained that the decrease in the blood flow velocity in patients of both groups reduced the diameter of the celiac trunk. Conclusions. In patients with diabetes mellitus type II, concomitant gastroesophageal reflux disease has a subtle clinical presentation that is affected by a significant decline in mucosal sealing protection factors. In patients with GERD without associated pathology, typical clinical manifestations, accompanied by inflammation, acid regurgitation and dyspepsia, are more vivid.


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