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A case of treatment-induced neuropathy in an adolescent with type 1 diabetes

Annals of Pediatric Endocrinology & Metabolism 2019년 24권 3호 p.203 ~ 206
 ( Varadharaju Niranjana ) - Sri Ramachandra Medical College

 ( Jeevarathnam Dhivyalakshmi ) - Sri Ramachandra Medical College Department of Pediatrics
 ( Rajan Mahalakshmi ) - Sri Ramachandra Medical College Department of Pediatrics
 ( Nagarajan Vinoth Ponnurangam ) - Sri Ramachandra Medical College Department of Pediatrics
 ( James Saji ) - Sri Ramachandra Medical College Department of Pediatrics


Treatment-induced neuropathy (TIN) in diabetes is an acute and painful yet completely reversible small fiber neuropathy precipitated by a rapid improvement in glycemic control. TIN is rare in children. A 16-year-old girl developed symmetrical painful neuropathy of the foot, autonomic neuropathy, and retinopathy 5 weeks after the diagnosis of type 1 diabetes. All causative workups were negative except for a drop-in hemoglobin A1c (HbA1c) from 17.4% to 7%, which fit with a diagnosis of TIN. Following symptomatic management, her neuropathy and retinopathy completely resolved in 2 months. Currently, she is 18 years old and doing well (HbA1c, 7.4%) without any recurrence of TIN. TIN should be suspected in any child presenting with recent-onset type 1 diabetes and acute onset neuropathy. Our case represents an unreported scenario of the rapid progression in TIN. Awareness among clinicians about this rare but completely reversible condition is necessary to ensure proper management and adherence to glycemic control.


Painful neuropathy; Autonomic neuropathy; Type 1 diabetes mellitus; Child; Glycemic control
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