Lymphoscintigraphy in diabetic – case report
Authors:
Otto Lang 1,2,5; Věra Prýmková 3; Barbora Daňhová 4
Authors‘ workplace:
Klinika nukleární medicíny, 3. LF a FN Královské Vinohrady, Praha 10
1; Oddělení nukleární medicíny
2; Interní oddělení
3; Oddělení rehabilitace, ON Příbram, a. s.
4; Odděllení nukleární medicíny, PMCD s. r. o., Praha 6, ČR
5
Published in:
NuklMed 2022;11:32-35
Category:
Casuistry
Overview
Introduction: Diabetic microangipathy is one of the most serious complication of diabetes mellitus. More factors take part in this issue, the most important is neuropathy and increased pressure in the venous system as a result of venous perforators or valves insufficiency of deep venous system in postflebitic syndrome. High perfusion microangopathy is a result of these changes. It is characterized by increased capillary permeability and increased proteins and liquids filtration into the interstitium. The final result is edema. Skin and tissues necrosis due to nutritious capillaries compression and worsened gases and substances diffusion through the edema can be a result. Our case report shows the use of lymphoscintigraphy for the assessment of interstitium volume load and the effect of lymphodrainage to the patient difficulties.
Case report: 73-y-old female was sent to our department for the assessment of lymphatic system of lower extremities. She had a diabetes mellitus type 2 for 8 years, she was treated with a diet and oral antidiabetics. She was obese, had a hypertension and early stage of renal insufficiency. Diabetic polyneuropathy was also diagnosed. She felt a feet discomfort with a feeling of stiffness and heaviness; no edemas or skin defect was present. Lymphoscintigraphy of the lower extremities was performed. It confirmed significantly increased lymphatic transport in both legs, namely after walk load, with an appearance of skin collaterals. Manual and device lymphodrainage was indicated, 6 application each. Patient difficulties disappeared afterwards.
Conclusion: Our case report illustrates the significance of lymphoscintigraphy for the detection of subclinical edema of lower extremities and the effectivity of lymphodrainage to the patient difficulties. Believe this procedure can contribute to the timely diagnosis of the microcirculation disorders. Thus, it can help to prevent serious complication in the form of development of diabetic foot syndrome.
Keywords:
diabetic foot syndrome – polyneuropathy – lymphoscintigraphy
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Nuclear medicine Radiodiagnostics RadiotherapyArticle was published in
Nuclear Medicine
2022 Issue 2
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