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Diagnosis and Treatment > Signs and Symptoms

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Dured Dardari Diabetology Department, Centre Hopitalier Sud Francilien, Corbeil-Essonnes, France
Sorbonne Université, Paris, France

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Alfred Penfornis Diabetology Department, Centre Hopitalier Sud Francilien, Corbeil-Essonnes, France
Paris-Sud Medical School, Paris-Saclay University, Orsay, France

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Agnes Hartemann Diabetology Department, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
Sorbonne Université, Paris, France

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Summary

We report the onset of acute Charcot neuroarthropathy during pregnancy in two patients with type 1 diabetes using retrospective review of case notes. We describe for the first time the onset of acute Charcot neuroarthropathy during pregnancy in two patients with type 1 diabetes. Pregnancy may promote the onset and worsening of a number of diabetic complications. A link between pregnancy and the onset of acute Charcot neuroarthropathy is demonstrated for the first time in this report.

Learning points:

  • Patients with already diagnosed sensitive neuropathy can develop an active phase of Charcot neuroarthropathy during pregnancy.

  • The rapid correction of hyperglycaemia may induce an active phase of Charcot neuroarthropathy during pregnancy.

Taxonomy:
Clinical Overview, Gland/Organ, Bone, Topic, Bone, Hormone, Insulin, Condition/ Syndrome, Diabetes mellitus type 1, Diabetic nephropathy, Hyperglycaemia, Thyroiditis, Patient Demographics, Age, Adult, Gender, Female, Ethnicity, White, Country of Treatment, France, Diagnosis and Treatment, Signs and Symptoms, Diabetes mellitus type 1, Diabetic neuropathy, Diabetic nephropathy, Feet - increased size, Hyperglycaemia, Microalbuminuria, Oedema, Paraesthesia, Retinopathy, Vomiting, Investigation, Albumin, Haemoglobin A1c, Ultrasound scan, Medication, Corticosteroids, Iron supplements, Insulin, Prednisone, Related Disciplines, Podiatry, Publication Details, Case Report Type, Insight into disease pathogenesis or mechanism of therapy
DOI:
https://doi.org/10.1530/EDM-20-0002
Volume/Issue:
Volume 2020: Issue 1
Open access
Anna Luiza Galeazzi Rech Kantonsspital Sankt Gallen, Klinik für Allgemeine Innere Medizin/Hausarztmedizin, Sankt Gallen, Switzerland

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Yvon Stüve Kantonsspital Sankt Gallen, Klinik für Allgemeine Innere Medizin/Hausarztmedizin, Sankt Gallen, Switzerland

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Andreas Toepfer Kantonsspital Sankt Gallen, Klinik für Orthopädische Chirurgie und Traumatologie des Bewegungsapparts, Sankt Gallen, Switzerland

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Katrin E Schimke Kantonsspital Sankt Gallen, Klinik für Allgemeine Innere Medizin/Hausarztmedizin, Sankt Gallen, Switzerland

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Summary

Acute Charcot neuropathic osteoarthropathy (CN) is a clinical entity which can easily go unrecognized in its acute early stages due to lack of awareness and unspecific presentation. However, missing early diagnosis can lead to severe complications. We present the case of a 72-year-old male patient who went through the natural course of the disease unnoticed before the very eyes of his physicians leading to a tragic end. We aim to raise awareness for this rare diabetic complication, emphasizing the necessity of early diagnosis and adequate, interdisciplinary treatment.

Learning points:

  • Clinical signs and symptoms of acute Charcot neuropathic osteoarthropathy (CN).

  • Red flags.

  • Importance of early diagnosis and correct treatment.

  • Diagnostic challenges of acute CN.

  • Awareness of high morbidity and mortality.

Taxonomy:
Clinical Overview, Gland/Organ, Bone, Topic, Bone, Hormone, Insulin, Condition/ Syndrome, Diabetes mellitus type 2, Diabetic foot syndrome, Patient Demographics, Age, Geriatric, Gender, Male, Ethnicity, White, Country of Treatment, Switzerland, Diagnosis and Treatment, Signs and Symptoms, Erythema, Feet - increased size, Feet - pain, Hyperthermia, Leg pain, Nephropathy, Oedema, Investigation, Angiography, Brain natriuretic peptide, C-reactive protein, Estimated glomerular filtration rate, Haemoglobin A1c, MRI, Skin biopsy, White blood cell count, X-ray, Intervention, Amputation, Angioplasty, Medication, Amoxicillin, Diuretics, Related Disciplines, Geriatrics, Podiatry, Radiology/Rheumatology, Publication Details, Case Report Type, Error in diagnosis/pitfalls and caveats
DOI:
https://doi.org/10.1530/EDM-20-0013
Volume/Issue:
Volume 2020: Issue 1
Open access