Diabetic muscle infarction after simultaneous pancreas-kidney transplant.
Diabetic muscle infarction (DMI) is a rare entity that occurs in patients with long-standing type 1 insulin dependent diabetes mellitus (IDDM). We describe DMI occurring on an average of 5 months after SPK in four patients with IDDM and end stage renal disease (ESRD). These patients had evidence of other long-term diabetic complications including retinopathy and neuropathy, as well as microangiopathy and hypercoagulability, both of which are pre-disposing factors for DMI. The etiology of DMI is not well understood. Despite establishment of normoglycemia after kidney-pancreas transplantation, DMI may occur as a result of tissue damage/fragility secondary to the pre-existing long-term labile glycemic control and hypertension. This may be exacerbated by the pro-coagulant effects of the calcineurin-inhibitors and the use of steroids as part of the immunosuppressive regimen.
Delis
Spiros
S
Department of Surgery, Division of Transplantation, University of Miami School of Medicine, Miami, FL 33101, USA.
Ciancio
Gaetano
G
Casillas
Javier
J
Figueiro
Jose
J
Garcia
Alvaro
A
Miller
Joshua
J
Burke
George W
GW
D000328:Adult; D015984:Causality; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000601:surgery; D003929:Diabetic Neuropathies / Q000150:complications; D003930:Diabetic Retinopathy / Q000150:complications; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007238:Infarction / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery; D016030:Kidney Transplantation; D018482:Muscle, Skeletal / Q000098:blood supply*; D016035:Pancreas Transplantation
D007166:Immunosuppressive Agents