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Mononeuritis multiplex in diabetes mellitus: evidence for underlying immune pathogenesis
  1. P Kelkar1,
  2. G J Parry2
  1. 1Department of Neurology, University of Iowa, Iowa City, Iowa, USA
  2. 2Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
  1. Correspondence to:
 Dr Praful Kelkar, Department of Neurology 2RCP, University of Iowa Hospitals, 200 Hawkins Drive, Iowa City, IA 52242, USA; 
 praful-kelkar{at}uiowa.edu

Abstract

Four patients with type 2 diabetes mellitus developed mononeuritis multiplex subacutely. Sural nerve biopsies showed multifocal axonal loss in all patients, with epineurial perivascular inflammation affecting small calibre vessels in three. Three patients improved with immunotherapy. These observations suggest that mononeuritis multiplex in diabetes may be caused by an immune mediated vasculopathy and that it is pathogenetically akin to the more common and better recognised diabetic amyotrophy.

  • diabetic neuropathy
  • mononeuritis multiplex
  • inflammatory neuropathy

https://doi.org/10.1136/jnnp.74.6.803

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    Footnotes

    • Competing interests: none declared