Recurrent Diabetic Muscle Infarction in A Patient on Maintenance Hemodialysis

Korean Journal of Nephrology 2007;26(4):502-507.

Yeo Kyung Lee, M.D., Ju-Hee Oh, M.D., Do Hyung Kim, M.D., Jeong Hwan Yoo, M.D., Dong Ho Yang, M.D. and Hyung-Jong Kim, M.D.

Department of Internal Medicine, College of Medicine, Pochon CHA University, Sungnam, Korea

혈액투석 환자에서 발생한 반복적인 당뇨병성 근육 경색증 1예

이여경

포천중문의과대학 분당차병원 내과학교실

Abstract

Diabetic muscle infarction (DMI) is a rare complication that usually occurs in diabetic patients with advanced microvascular complication. DMI presents with abrupt or subacute onset of pain, tenderness and swelling of a localized muscle group in the lower extremities in most instances. It is usually improved by conservative management such as avoiding weight bearing or pain control, but recurs frequently in 50% of the patients. The diagnosis is based on magnetic resonance imaging (MRI), which is not specific but highly indicative. A forty-nine-years-old female on hemodialysis was admitted presenting with severe pain and swelling of right thigh. To evaluate the causes of leg swelling, angiography and MRI in both legs and muscle biopsy at right thigh were performed. There was no deep vein thrombosis and arteriosclerosis in the lower extremities on angiography. The patient was diagnosed to DMI by MRI. After conservative treatment such as administration of analgesics, anti-platelet agent and physical therapy, pain and swelling of thigh was diminished, but frequently recurred. We describe a case of recurrent diabetic muscle infarction in a patient with maintenance hemodialysis therapy.

Key Words: Infarction, Diabetes mellitus, Dialysis