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Clinico‐pathological features of postural hypotension in diabetic autonomic neuropathy
Author(s) -
Khawaja K. I.,
Walker D.,
Hayat S. A.,
Boulton A. J. M.,
Malik R. A.
Publication year - 2000
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2000.00238.x
Subject(s) - medicine , microangiopathy , supine position , orthostatic vital signs , pathological , nephropathy , diabetes mellitus , retinopathy , blood pressure , proteinuria , diabetic neuropathy , diabetic nephropathy , anesthesia , endocrinology , kidney
Summary We report the clinico‐pathological features and management of a 49‐year‐old male with a 30‐year history of Type 1 diabetes mellitus who had nephropathy (proteinuria 1.81 g/24 h, creatinine 136 μmol/l), proliferative retinopathy and severe somatic and autonomic neuropathy. A sural nerve biopsy demonstrated marked myelinated fibre loss with unmyelinated fibre degeneration and regeneration combined with extensive endoneurial microangiopathy. The management of the patient's blood pressure problems (supine hypertension) and symptomatic postural hypotension is discussed.