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Neuropathy in Diabetes

Not a Knee-Jerk Diagnosis

Lee C. Rogers, DPM ^*, Nicholas J. Bevilacqua, DPM ^*, Rayaz A. Malik, MBChB, MRCP, PhD  and David G. Armstrong, DPM, PhD 

^* Amputation Prevention Center, Broadlawns Medical Center, Des Moines, IA.
Cardiovascular Research Group, Division of Cardiovascular and Endocrine Sciences, Department of Medicine, Manchester Royal Infirmary and Manchester University, Manchester, England.
Center for Lower Extremity Ambulatory Research (CLEAR), Dr. William M. Scholl College of Podiatric Medicine, North Chicago, IL.

Corresponding author: Lee C. Rogers, DPM, Amputation Prevention Center, Broadlawns Medical Center, 1801 Hickman Rd, Des Moines, IA 50314. (E-mail: Lee.C.Rogers @gmail.com)

Abstract

Neuropathic symptoms in patients with diabetes occur commonly and are most often a consequence of the diabetes. Up to 10% of patients with diabetes and neuropathy have an etiology other than diabetes as a cause of their nerve dysfunction. Herein we present a case of vasculitic neuropathy initially misdiagnosed as diabetic neuropathy that led to separate amputations of two toes. This case emphasizes the importance of considering alternative, potentially treatable, causes of peripheral neuropathy in patients with diabetes. (J Am Podiatr Med Assoc 98(4): 322–325, 2008)