Abstract Details

Study of sympathetic skin response in diabetic patients with soft tissue rheumatism of the hand

Background: Physicians have long recognized the association between diabetes mellitus (DM) and several pathologic conditions of the hand. The most commonly recognized conditions are trigger finger, tenosynovitis, Dupuytren's disease (DD), carpal tunnel syndrome (CTS), and limited joint mobility (LJM). However, there is a paucity of data regarding the presence of a possible relation between diabetic hand soft tissue lesions and diabetic autonomic neuropathy. Aim: To investigate the relationship between sympathetic dysfunction and soft tissue rheumatisms of the hand in diabetic patients. Patients: the study included 3 groups .Group 1 contained 20 diabetic patients with one or more of the previously mentioned hand soft tissue lesions. Group 2 contained 20 diabetic patients without any hand pathology and 20 healthy control subjects. Methods: Patients with DM were thoroughly evaluated clinically and were assessed for the presence of diabetic autonomic neuropathy (DAN) using tilt table test before proceeding to the electrophysiological measurements. Electrodiagnostic techniques included (1) sensory conduction studies of median, ulnar, and superficial radial nerves. (2) Motor conduction studies of median and ulnar nerves. (3) Sympathetic skin response (SSR). Results: 5 patients had trigger finger, 2 had tenosynovitis, 1 had Dupuytren's contracture, 6 had CTS, and 2 had LJM. In addition, 4 patients had combined CTS and trigger finger. Abnormal SSR was detected in 10 patients in group 1 and in 11 patients in group 2(in the form of absent response or delayed latencies). There was no statistically significant difference between group 1 and 2 regarding the frequency of SSR abnormalities. There was a statistically significant relationship between the presence of CTS in group1 patients and abnormal SSR results. There was statistically significant relationship between positive tilt table test results in group 1 patients and abnormal SSR in the same group. There was statistically significant relationship between the duration of DM and abnormal SSR results in group1 patients. There was no statistically significant relationship between the presence of DPN in group2 and abnormal SSR results in the same group. Conclusions: diabetic patients with CTS tend to have prolonged SSR of the hand .further studies are recommended to study other factors responsible for the occurrence of diabetic soft tissue lesions Key words: diabetic hand soft tissue lesions, diabetic autonomic neuropathy, sympathetic skin response of the hand. ABBREVIATIONS: DM: Diabetes Mellitus DD: Dupuytren's Disease CTS: Carpal Tunnel Syndrome LJM: Limited Joint mobility DAN: Diabetic Autonomic Neuropathy SSR: Sympathetic Skin Response

TitleForenamesSurnameInstitutionLead AuthorPresenter
DrSarahNaeemFaculty of medicine, Helwan university
Dr HusseinAl-MoghazyFaculty of medicine, Alexandria University
DrDiaaMohassebFaculty of medicine , Alexandria University
No references