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Diabetic muscle infarction after simultaneous pancreas‐kidney transplant
Author(s) -
Delis Spiros,
Ciancio Gaetano,
Casillas Javier,
Figueiro Jose,
Garcia Alvaro,
Miller Joshua,
Burke George W
Publication year - 2002
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1034/j.1399-0012.2002.01151.x
Subject(s) - medicine , pancreas transplantation , diabetes mellitus , microangiopathy , calcineurin , transplantation , kidney , infarction , insulin , type 1 diabetes , etiology , surgery , kidney disease , glycemic , pancreas , kidney transplantation , endocrinology , myocardial infarction
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.