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Published 23 January 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.08.2008.0656]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Intravenous immunoglobulin therapy in proximal diabetic neuropathy

Yuichi Kawagashira, Hirohisa Watanabe, Yumiko Oki, Masahiro Iijima, Haruki Koike, Naoki Hattori, Masahisa Katsuno, Fumiaki Tanaka, Gen Sobue

Nagoya University Graduate School of Medicine, Nagoya, Nagoya, 466-8550, Japan

Correspondence to:
sobueg{at}med.nagoya-u.ac.jp

SUMMARY

A 57-year-old man with type 2 diabetes mellitus for 10 years showed progressive loss of muscle strength in both legs, pain and muscle atrophy in the femoral region and significant weight loss. On admission, he could not stand alone and used a wheelchair. He also complained of severe pain in the lower extremities. He was diagnosed with proximal diabetic neuropathy (PDN) by characteristic clinical and electrophysiological features. Intravenous immunoglobulin therapy (IVIg 0.4 g/kgx5 days) markedly reduced the severe pain and muscle weakness in the legs. Eventually, pain assessed by the Visual Analogue Scale was relieved by 80% and muscle strength was also well recovered, thereby enabling the patient to walk with a cane. The present case suggests that IVIg therapy may be effective for the relief of pain in PDN.


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