2015, Número 1
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Rev Cuba Endoc 2015; 26 (1)
Síndrome de la mano diabética, a propósito de tres casos con limitación de la movilidad articular y lesiones complicadas del pie
García GY, Miranda BA, Estévez PA, Valdés RA, Barnés DJA
Idioma: Español
Referencias bibliográficas: 60
Paginas: 33-46
Archivo PDF: 207.08 Kb.
RESUMEN
Introducción: la diabetes mellitus está asociada a una gran variedad de alteraciones músculo esqueléticas en las manos. El término
síndrome de la mano
diabética aparece con frecuencia en la literatura médica, aunque no existe una definición precisa, y hasta la fecha no se ha reconocido como una complicación
específica de la enfermedad. El examen físico para la identificación temprana de estas alteraciones podría evitar la discapacidad de las formas severas.
Objetivos: describir las alteraciones músculo esqueléticas más frecuentes en las manos de las personas con diabetes, a propósito de 3 pacientes con limitación de la movilidad articular, hospitalizados por lesiones complicadas del pie.
Desarrollo: entre las alteraciones más frecuentes de la mano en las personas con
diabetes está la limitación de la movilidad articular, la contractura de Dupuytren, el
dedo en gatillo, la neuropatía ulnar y el túnel carpiano. Cada una tiene sus
particularidades y pueden ser fácilmente diagnosticadas con el examen físico. Se
asocian con la duración de la enfermedad, el pobre control metabólico y la
presencia de complicaciones microvasculares, como en los casos que se presentan,
con limitación de la movilidad articular severa. Estas deformidades afectan las
actividades de la vida diaria, y por tanto, la calidad de vida de los pacientes,
además, orientan al médico en la búsqueda de complicaciones microvasculares no
diagnosticadas, de ahí la importancia de detectarlas.
Conclusiones: se establece que la identificación temprana de las alteraciones en
las manos de los diabéticos tiene importantes implicaciones individuales y
sanitarias, por lo que su examen periódico debe ser realizado a todos los pacientes.
REFERENCIAS (EN ESTE ARTÍCULO)
Lebiedz-Odrobina D, Kay J. Rheumatic manifestation of diabetes mellitus. Rheum Dis Clin N Am. 2010;36:681-99.
Papanas N, Maltezos E. The diabetic hand: a forgotten complication? J Diabetes Complications. 2010;24:154-62.
Fernando DJS, Masson EA, Veves A, Boulton AJM. Relationship of limited joint mobility to abnormal foot pressures and diabetic foot ulceration. Diabetes Care. 1991;1:8-11.
Schiavon F, Circhetta C, Dani L. The diabetic hand. Reumatismo. 2004;56:139-42.
Attar SM. Musculoskeletal manifestations in diabetic patients at a tertiary center. Libyan J Med. 2012;7:19162-9.
Smith LL, Burnet SP, McNeil JD. Musculoskeletal manifestations of diabetes mellitus. Br J Sports Medic. 2003;37:30-5.
Arkkila PE, Gautier JF. Musculoskeletal disorders in diabetes mellitus: an update. Best Pract Res Clin Rheumatol. 2003;17:945-70.
Ramchurn N, Mashamba C, Leitch E, Arutchelvam V, Narayanan K, Weaver J, et al. Upper limb musculoskeletal abnormalities and poor metabolic control in diabetes. Eur J Intern Med. 2009;20:718-21.
Mota M, Panuş C, Mota E, Sfredel V, Patraşcu A, Vanghelie L, et al. Hand abnormalities of the patients with diabetes mellitus. Rom J Intern Med. 2000- 2001;38-39:89-95.
Redmond CL, Bain GI, Laslett LL, McNeil JD. Hand syndromes associated with diabetes: impairments and obesity predict disability. J Rheumatol. 2009;36:2766-71.
Savaş S, Köroğlu BK, Koyuncuoğlu HR, Uzar E, Celik H, Tamer NM. The effects of the diabetes related soft tissue hand lesions and the reduced hand strength on functional disability of hand in type 2 diabetic patients. Diabetes Res Clin Pract. 2007;77:77-83.
Melamed E, Goldstein S, Angel D. Hand disorders in diabetic patients. Harefuah. 2010;149:382-6.
Rosenbloom AL. Limited Joint Mobility in Childhood Diabetes: Discovery, Description, and Decline. J Clin Endocrinol Metab. 2013;98:466-73.
Al-Matubsi HY, Hamdan F, Alhanbali OA, Oriquat GA, Salim M. Diabetich and syndromes as a clinical and diagnostic tool for diabetes mellitus patients. Diabetes Res Clin Pract. 2011;94:225-9.
Rosenbloom AL, Frias JL. Diabetes mellitus, short stature, and joint stiffness: a new syndrome. Clin Res. 1974;22:92A.
Rosenbloom AL, Silverstein JH, Lezotte DC, Richardson K, McCallum M. Limited joint mobility in childhood diabetes mellitus indicates increased risk for microvascular disease. N Engl J Med. 1981;305:191-4.
Petrulewicz-Salamon I. The influence of diabetes mellitus on joint mobility. Ortop Traumatol Rehabil. 2006;31:555-65.
Lindsay JR, Kennedy L, Atkinson AB, Bell PM, Carson DJ, Mc Cance DR, et al. Reduced prevalence of limited joint mobility in type 1 diabetes in a U.K. clinic population over a 20-year period. Diabetes Care. 2005;28:658-61.
Infante JR, Rosenbloom AL, Silverstein JH, Garzarella L, Pollock BH. Changes in frequency and severity of limited joint mobility in children with type 1 diabetes mellitus between 1976-78 and 1998. J Pediatr. 2001;138:33-7.
Larkin ME, Barnie A, Braffett BH, Cleary PA, Diminick L, Harth J. Musculoskeletal Complications in Type 1 Diabetes. Diabetes Care. 2014;37:1863-9.
Pandey A, Usman K, Reddy H, Gutch M, Jain N, Qidwai S. Prevalence of hand disorders in type 2 diabetes mellitus and its correlation with microvascular complications. Ann Med Health Sci Res. 2013;3:349-54.
Crispin JC, Alcocer-Varela J. Rheumatologic manifestations of diabetes mellitus. Am J Med. 2003;114:753-7.
Vera González M, Orlandi González N, Luis S, Licea Puig M. Polineuropatía diabética periférica en diabéticos tipo 1 con limitación de los movimientos articulares (LMA). Rev Cubana Endocrinol [serie en Internet]. 2007 Ago [citado 2 de noviembre de 2013];18(2). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561- 29532007000200003&lng=es
Arkkila PE, Kantola IM, Viikari JS, Ronnemaa T, Vahatalo MA. Limited joint mobility is associated with the presence but does not predict the development of microvascular complications in type 1 diabetes. Diabet Med. 1996;13:828-33.
Abate M, Schiavone C, Salini V, Andia I. Management of limited joint mobility in diabetic patients. Diabetes Metab Syndr Obes. 2013;6:197-207.
Sauseng S, Kästenbauer T, Irsigler K. Limited joint mobility in selected hand and foot joints in patients with type 1 diabetes mellitus: a methodology comparison. Diabetes Nutr Metab. 2002;15:1-6.
Rosenbloom AL. Limitation of finger joint mobility in diabetes mellitus. J Diabet Complications. 1989;3:77-87.
Rayan GM. Dupuytren disease: anatomy, pathology, presentation, and treatment. J Bone Joint Surg Am. 2007;89:189-98.
Hart MG, Hooper G. Clinical associations of Dupuytren’s disease. Postgrad Med J. 2005;81:425-8.
Noble J, Heathcote JG, Cohen H. Diabetes mellitus in the etiology of Dupuytren's disease. J Bone Joint Surg. 1984;66:322-5.
Childs SG. Dupuytren's disease. Orthopaedic Nursing. 2005;24:160-4.
Shih B, Bayat A. Scientific understanding and clinical management of Dupuytren's disease. Nat Rev Rheumatol. 2010;6:715-26.
Mann RJ, Peacock JM. Hand infections in patients with diabetes mellitus. J Trauma. 1977;17:376-80.
Akiniewe TA. The diabetic hand: 5 illustrative case reports. Br J Clin Pract. 1984;3S:368-71.
Gill GV, Famuyiwa OO, Rolfe M, Archibald LK. Tropical diabetic hand syndrome. Lancet. 1998;351:113-4.
Abbas ZG, Lutale J, Gill GV, Archibald LK. Tropical diabetic hand syndrome: risk factors in an adult diabetic population, Tanzania. Int J Infect Dis. 2001;5:19-23.
Abbas ZG, Gill GV, Archibald LK. The epidemiology of diabetic limb sepsis: An African perspective. Diabetic Medicine. 2002;19:895-9.
Houshian S, Seyedipour S, Wedderkopp N. Epidemiology of bacterial hand infections. Int J Infect Dis. 2006;10:315-9.
Ezeani IU. Case series on tropical diabetic hand syndrome. Niger J Clin Pract. 2014;17:540-2.
Betotmane A, Faraoun K, Mohhamedi F, Benkhelifa T, Amani ME. Infections of the upper extremity in hospitalized diabetic patients, a prospective study. Diabetes Metab. 2004;30:91-7.
Zulfiqarali G, Abbas ZG, Archibald LK. Tropical Diabetic Hand Syndrome Epidemiology, Pathogenesis, and Management. Am J Clin Detmotol. 2005;6:21-8.
Tiwari S, Chauhan A, Sethi NT. Tropical diabetic hand syndrome. Int J Diab Dev Ctries. 2008;28:130-1.
Jalil A, Barlaan PI, Fung BK, Ip JW. Hand infection in diabetic patients. Hand Surg. 2011;16:307-12.
Tian M, Wang X, Xiao Y, Lu S, Jiang Y. A Rare Case of Diabetic Hand Ulcer Caused by Streptococcus agalactiae. Int J Low Extrem Wounds. 2012;11:174-6.
Archibald LK, Gill GV, Abbas Z. Fatal hand sepsis in Tanzanian diabetic patients. Diabet Med. 1997;14:607-10.
Wang C, Lv L, Wen X, Chen D, Cen S, Huang H, et al. A clinical analysis of diabetic patients with hand ulcer in a diabetic foot center. Diabet Med. 2010;27:848-51.
Arkkila PE, Kantola IM, Viikari JS, Ronnemaa T, Vahatalo MA, Aroori S, et al. Carpal tunnel syndrome. Ulster Med J. 2008;77:6-17.
Bland JD. Carpal tunnel syndrome. BMJ. 2007;335:343-6.
Ntani G, Palmer KT, Linaker C, Harris EC, Van der Star R, Cooper C, et al. Symptoms, signs and nerve conduction velocities in patients with suspected carpal tunnel syndrome. BMC Musculoskelet Disord. 2013;14:242-5.
van Rijn RM, Huisstede BM, Koes BW. Associations between work-related factors and the carpal tunnel syndrome: a systematic review. Scand J Work Environ Health. 2009;35:19-36.
Bahrmann A, Zieschang T, Neumann T, Hein G, Oster P. Carpal tunnel syndrome in diabetes mellitus. Med Klin. 2010;105:150-4.
Vinik A, Merabayan A, Colen L, Boulton A. Focal entrapment neuropathies in diabetes. Diabetes Care. 2004;27:1783-8.
Thomsen NOB, Cederlund R, Bjork J, Dahlin LB. Original Article: Education and Psychological Aspects Health-related quality of life in diabetic patients with carpal tunnel syndrome. Diabet Med. 2010;27:466-72.
Boulton AJ, Vinik AI, Arezzo JC, Bril V, Feldman EL, Freeman R, et al. Diabetic neuropathies: A statement by the American Diabetes Association. Diabetes Care. 2005;28:956-62.
Coppini DV, Best C. A case of hand ulceration in the diabetic foot clinic-A reminder of hand neuropathy in “at risk patients”. Diabetic Medicine. 2000;17:682-3.
Morbach S, Möllenberg J, Quante C, Rüther U, Rempe D, Ochs HR. Coincidence of hand and foot ulceration in people with diabetes. Diabetic Medicine. 2001;18:514-5.
Redmond CL, Bain GI, Laslett LL, McNeil JD. Deteriorating tactile sensation in patients with hand syndromes associated with diabetes: a two-year observational study. J Diabetes Complications. 2012;26:313-8.
Ulrich Illgner U, Netten J, Droste C, Meiners T, Postema K, Wetz HH. Diabetic Charcot Neuroarthropathy of the Hand: Clinical Course, Diagnosis, and Treatment Options. Diabetes Care. 2014;37:e91-e92.
Lambert AP, Close CF. Charcot neuroarthropathy of the wrist in Type 1 diabetes. Diabetes Care. 2005;28:984-5.
Wróbel M, Szymborska-Kajanek A, Skiba M. Charcot’s joint of the wrist in type 2 diabetes mellitus. Exp Clin Endocrinol Diabetes. 2007;115:55-7.