Abstract
We repeatedly admitted to our department an obese patient with type 2 diabetes mellitus and long lasting unsatisfactory metabolic compensation. During the first hospitalization the patient took part in a program of weight reduction that resulted in the weight loss of 3 kg.
At the same time we adjusted her treatment. Six months later she was hospitalized again with lumbosacral pain irradiating to both legs.
The pain as well as muscle atrophy significantly limited her mobility. She reported unwanted weight loss, loss of appetite and general exhaustion.
We considered GIT neoplasm because of tumor markers elevation. Repeated examinations excluded compressive, paraneoplastic and inflammatory etiology of the symptoms.
Based on examination results and long lasting metabolic decompensation of diabetes mellitus the fast progress of diabetic neuropathy (Burns-Garland neuropathic syndrome) was very likely. The neuropathy became a target of the treatment.
The real cause of the symptoms was subsequently revealed by MRI of lumbosacral region that showed L3/4 discs herniation with dural sac compression. Partial reposition of L3/4 was performed; patient is able to walk with crutches and pain symptoms abated.