title: An unusual cause of bilateral massive peripheral edema in a young male with type 1 diabetes mellitus.
abstract: The present article demonstrates an unusual case of bilateral massive peripheral edema caused by neurogenic areflexic bladder in diabetes mellitus type 1. A 28-year-old patient with diabetes type 1 treated for a number of years was referred to the department of internal medicine because of massive edema of his lower limbs. Blood samples revealed increased concentrations of glucose (21.2 mmol/L) and glycated hemoglobin (8.5%). The computed tomography examination of abdomen and pelvis confirmed enlargement of the bladder, with smooth external contour and normal wall thickness. In addition, computed tomography demonstrated bilateral compression of the iliac veins caused by the enlarged bladder. This case highlights the importance of keeping a broad differential diagnosis in mind for patients with diabetes and massive peripheral edema. Neurogenic bladder should be considered in the differential diagnosis, especially for patients with poor glycemia control and long-standing diabetes complicated by diabetic neuropathy.
authors.affiliation: Department of Radiology and Diagnostic Imaging, 4th Military Hospital, Wroclaw, Poland. Electronic address: pawelgac@interia.pl.
authors.forename: Paweł
authors.initials: P
authors.lastname: Gać
authors.affiliation: Department of Radiology and Diagnostic Imaging, 4th Military Hospital, Wroclaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Stoinska
authors.affiliation: Department of Internal Medicine, 4th Military Hospital, Wroclaw, Poland.
authors.forename: Kamila
authors.initials: K
authors.lastname: Balawejder
authors.affiliation: Department of Radiology and Diagnostic Imaging, 4th Military Hospital, Wroclaw, Poland.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Jaźwiec
authors.affiliation: Department of Radiology and Diagnostic Imaging, 4th Military Hospital, Wroclaw, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Miszalski-Jamka
authors.affiliation: Department of Internal Medicine, 4th Military Hospital, Wroclaw, Poland; Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Szuba
mesh_terms: D000328:Adult; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D003937:Diagnosis, Differential; D004487:Edema / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007084:Iliac Vein / Q000000981:diagnostic imaging / Q000473:pathology*; D007328:Insulin / Q000008:administration & dosage; D007866:Leg / Q000473:pathology*; D008297:Male; D010353:Patient Education as Topic; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: compression des veines iliaques; compression of iliac veins; diabetes mellitus type 1; diabète sucré de type 1; neurogenic bladder; peripheral edema; vessie neurogène; œdème périphérique