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Erythromelia, or Mitchell's syndrome – new names for unexplained signs of inflammation in distal symmetrical neuropathy in diabetes
Author(s) -
Jeffcoate W. J.,
Idris I.,
Game F. L.
Publication year - 2004
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 - 10.1111/j.1464-5491.2004.01346.x
Subject(s) - medicine , diabetes mellitus , vasodilation , reflex , limiting , diabetic neuropathy , complex regional pain syndrome , dermatology , dystrophy , surgery , anesthesia , pathology , endocrinology , mechanical engineering , engineering
Background Two cases are described in which distal symmetrical sensorimotor neuropathy complicating diabetes was associated with episodes of subacute vasodilation of one or other lower limb, and which were otherwise unexplained. The vasodilation was associated with swelling and stiffness, but was painless and self‐limiting. Interpretation It is suggested that this phenomenon results from disordered vasoregulation in diabetic neuropathy, and is linked to the processes which underlie diabetic neuropathic osteoarthropathy (Charcot foot), as well as disorders such as complex regional pain syndrome‐1 (CRPS‐1, reflex sympathetic dystrophy) and erythromelalgia. Conclusions As self‐limiting vasodilation may be not uncommon in distal symmetrical neuropathies, but unrecognized because the phenomenon has not been named, the terms ‘neuropathic erythromelia’ or ‘Mitchell's syndrome’ are proposed. The adoption of either of these names may lead to earlier diagnosis and prevent inappropriate investigation and treatment.