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Lancet Diabetes Endocrinol 2020 Jul;8(7):594-605

Academic Center For Thyroid Disease, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, Netherlands. Electronic address:

Background: Disordered thyroid hormone transport, due to mutations in the SLC16A2 gene encoding monocarboxylate transporter 8 (MCT8), is characterised by intellectual and motor disability resulting from cerebral hypothyroidism and chronic peripheral thyrotoxicosis. We sought to systematically assess the phenotypic characteristics and natural history of patients with MCT8 deficiency.

Methods: We did an international, multicentre, cohort study, analysing retrospective data from Jan 1, 2003, to Dec 31, 2019, from patients with MCT8 deficiency followed up in 47 hospitals in 22 countries globally. Read More

Rheumatology (Oxford) 2020 Jun 4. Epub 2020 Jun 4.

Muscle Research Unit, Internal Medicine Department, Hospital Clínic de Barcelona, Universidad de Barcelona and Center for Biomedical Research on Rare Diseases (CIBERER), Barcelona, Madrid.

Objectives: Statins are the cornerstone of the treatment and prevention of cardiovascular disease but have been associated with muscular side effects, among others. If patients are not properly evaluated, statin discontinuation may take place, leaving patients' symptoms unresolved and precluding an effective cardiovascular treatment. The present study aims to describe the clinical characteristics, the diagnostic process and the final diagnosis of selected patients with suspected statin-induced myopathy, with quite different alternative diagnoses. Read More

J Clin Rheumatol 2020 Apr 25. Epub 2020 Apr 25.

Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan.

Drug Saf 2020 Apr 18. Epub 2020 Apr 18.

Team Pharmacoepidemiology, Bordeaux Population Health Research Center, Inserm U1219, Univ. Bordeaux, 33000, Bordeaux, France.

Introduction: After a safety warning was issued for a risk of muscular injury associated with dipeptidyl peptidase-4 (DPP-4) inhibitor use, especially when co-prescribed with statins, spontaneous reporting analyses provided conflicting results.

Objective: The aim of this study was to investigate the association between DPP-4 inhibitor use and the risk of muscular injury in individuals with type 2 diabetes mellitus using statins or fibrates.

Methods: We conducted a nested case-control study amongst a cohort of individuals with type 2 diabetes using statins or fibrates, identified from a nationwide French health insurance database (2009-2014). Read More

J Endocrinol Invest 2020 Jul 12;43(7):885-899. Epub 2020 Mar 12.

Endocrine Unit, Department of Medicine and Surgery, Ospedale Di Circolo, ASST Dei Sette Laghi, University of Insubria, Viale Borri, 57, Varese, Italy.

A complex relationship exists between thyroid and liver in health and disease. Liver plays an essential physiological role in thyroid hormone activation and inactivation, transport, and metabolism. Conversely, thyroid hormones affect activities of hepatocytes and hepatic metabolism. Read More

N Z Med J 2020 03 13;133(1511):86-89. Epub 2020 Mar 13.

Department of Orthopaedic Surgery, Middlemore Hospital, Counties Manukau District Health Board, Auckland.

J Med Case Rep 2020 Mar 2;14(1):38. Epub 2020 Mar 2.

Department of Urology and Endocrine Surgery, University Hospital of North Norway, Tromsø, Norway.

Background: Hoffmann's syndrome is a rare form of hypothyroid myopathy. Only a few cases of fasciotomy in this setting have previously been reported.

Case Presentation: A 41-year-old Caucasian man under treatment for hypothyroidism presented with acute-onset severe pain in his forearm for no obvious reason and was admitted to our emergency room. Read More

Eur J Cancer 2020 Feb 14;128:57-59. Epub 2020 Feb 14.

Department of Pulmonary and Critical Care Medicine, Peking Union Medical Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China. Electronic address:

Endocrinol Diabetes Metab Case Rep 2020 Feb 7;2020. Epub 2020 Feb 7.

Department of Medicine and College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Summary: Central diabetes insipidus (CDI) and several endocrine disorders previously classified as idiopathic are now considered to be of an autoimmune etiology. Dermatomyositis (DM), a rare autoimmune condition characterized by inflammatory myopathy and skin rashes, is also known to affect the gastrointestinal, pulmonary, and rarely the cardiac systems and the joints. The association of CDI and DM is extremely rare. Read More

Pediatr Nephrol 2020 Feb 3. Epub 2020 Feb 3.

Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

While nephropathic cystinosis is classically thought of as a childhood disease, with improved treatments, patients are more commonly living into adulthood. We performed a systematic review of the literature available on what complications this population faces as it ages. Nearly every organ system is affected in cystinosis, either from the disease itself or from sequelae of kidney transplantation. Read More

Medicine (Baltimore) 2020 Jan;99(3):e18878

Department of Endocrinology and Metabolism, Peking University Third Hospital, Beijing, China.

Rationale: Myalgia and elevated creatine kinase (CK) have been reported during the treatment of hyperthyroid patients. The causes of these symptoms are usually considered to be treatments of antithyroid drugs (ATDs), thyroidectomy or radio-iodine (131-I). However, the underlying cause may be the rapid correction of thyrotoxicosis (or relative hypothyroidism), which was usually neglected in clinical practice. Read More

BMJ Case Rep 2019 Dec 15;12(12). Epub 2019 Dec 15.

Endocrinology, Sri Ramachandra University Medical College, Chennai, Tamil Nadu, India

Zhonghua Nei Ke Za Zhi 2019 Dec;58(12):899-904

Department of Neurology, Peking University First Hospital, Beijing 100034, China.

To analyze the diagnostic value of skeletal muscle biopsy in patients with rhabdomyolysis. Clinical and pathological data of 26 patients with rhabdomyolysis from January 2002 to December 2018 undergoing muscle biopsy were collected. Eighteen males and 8 females were finally recruited with median age of 6-73 (37. Read More

N Engl J Med 2019 Nov;381(22):e39

Pediatr Ann 2019 Nov;48(11):e441-e447

Exocrine pancreatic insufficiency in children can lead to lifelong complications related to malnutrition and poor growth. The clinical presentation can be subtle in the early stages of insufficiency as the large functional capacity of the pancreas is gradually lost. The pediatrician plays a crucial role in the early identification of these children to ensure a timely referral so that a diagnosis can be made and therapy initiated. Read More

J Nutr Sci Vitaminol (Tokyo) 2019 ;65(5):451-454

KSO Corporation.

Serum bilirubin measurement is necessary to accurately distinguish jaundice from carotenemia. A 59.8-y old Japanese male showed symptoms of yellow skin pigmentation as a result of β-carotenemia. Read More

Best Pract Res Clin Rheumatol 2019 06 4;33(3):101433. Epub 2019 Oct 4.

Department of Neurology, University Medical Center Göttingen, Germany. Electronic address:

Myalgia is a common symptom of various neuromuscular disorders: myalgia occurs in metabolic muscle diseases, inflammatory muscle diseases, dystrophic myopathies and myotonic muscle disorders. Myalgia leads to a significantly reduced quality of life. Other muscular symptoms that are present along with myalgia often provide the clue towards a diagnosis and include weakness, cramps and myotonia as well as the type of pain. Read More

BMJ Case Rep 2019 Oct 5;12(10). Epub 2019 Oct 5.

General Internal Medicine, Hamad Medical Corporation, Doha, Qatar.

Neuropsychiatric and muscular symptoms can develop as part of hypothyroidism. However, frank psychosis or rhabdomyolysis due to hypothyroidism are uncommon and have been reported rarely as the first presenting features of hypothyroidism. We report a case of a 44-year-old man who presented with a 2-week history of delusions, hallucinations and mild bilateral leg pain, without apparent signs of myxedema. Read More

Future Med Chem 2019 08;11(16):2171-2192

AOU di Modena - Ospedale Civile di Baggiovara, UOC di Medicina ad indirizzo Metabolico-Nutrizionistico - Modena, Italy.

This review article aims to synthesize the evidence regarding nonalcoholic fatty liver disease (NAFLD) as a systemic disorder. We critically discuss the metabolic syndrome and its components; the cardiovascular and the endocrine system; chronic respiratory disorders; the musculoskeletal system; the skin; and extra-hepatic tumors. We conclude that, while some of these extra-hepatic conditions clearly predispose to the development of secondary forms of NAFLD (typically hypothyroidism-induced NAFLD), others result from pre-existent NAFLD (e. Read More

BMJ Case Rep 2019 Sep 6;12(9). Epub 2019 Sep 6.

Hospital Internal Medicine, Mayo Clinic, Phoenix, Arizona, USA.

An elderly woman with a history of hypertension, hypothyroidism, mesenteric vein thrombosis, depression and hyperlipidaemia on statins for >9 years presented with new-onset leg weakness, falls, dark-coloured urine, transaminitis and rhabdomyolysis (creatinine phosphokinase 12 896 U/L; aldolase 45.9 (normal <7.7 U/L). Read More

Cureus 2019 Jun 3;11(6):e4818. Epub 2019 Jun 3.

Internal Medicine, Northwell Health Mather Hospital, Port Jefferson, USA.

Hypothyroidism is frequently associated with myalgias, muscle stiffness, easy fatigability, and occasionally some degree of myopathy with mildly elevated muscle enzymes. Rarely, hypothyroidism may be complicated by rhabdomyolysis, the rapid destruction of skeletal muscle with myoglobin, creatine kinase, urate, and electrolytes release into the circulation. Recurrent cases of rhabdomyolysis are uncommon as most patients experience only one episode of rhabdomyolysis in their lifetime. Read More

Int J Appl Basic Med Res 2019 Jul-Sep;9(3):129-134

Department of Anatomical Sciences, University of Medicine and Health Sciences, Basseterre, St. Kitts and Nevis.

Postpolio syndrome (PPS) refers to a group of conditions that are present in patients, years after recovery from initial acute paralytic poliomyelitis. About 15%-80% of 20 million polio survivors worldwide will experience exacerbation of symptoms which typically appear 15-30 years after the resolution of initial poliomyelitis. Symptoms include new muscle weakness, fatigue, myalgia, joint pain, dysphagia, and difficulty breathing. Read More

Lancet Diabetes Endocrinol 2019 09 31;7(9):695-706. Epub 2019 Jul 31.

Academic Center for Thyroid Diseases, Erasmus Medical Centre, Rotterdam, Netherlands. Electronic address:

Background: Deficiency of the thyroid hormone transporter monocarboxylate transporter 8 (MCT8) causes severe intellectual and motor disability and high serum tri-iodothyronine (T) concentrations (Allan-Herndon-Dudley syndrome). This chronic thyrotoxicosis leads to progressive deterioration in bodyweight, tachycardia, and muscle wasting, predisposing affected individuals to substantial morbidity and mortality. Treatment that safely alleviates peripheral thyrotoxicosis and reverses cerebral hypothyroidism is not yet available. Read More

BMJ Case Rep 2019 Jul 27;12(7). Epub 2019 Jul 27.

Hull York Medical School, University of Hull, Hull, UK.

Muscular symptoms in hypothyroidism are common, including myalgia, fatigue and cramps; however, a significantly raised creatine kinase and muscle weakness are rare. Differential diagnosis of patients presenting with muscle weakness and a raised creatine kinase is wide, and hypothyroidism is rarely considered. We report this case of a 30-year-old female presenting with proximal muscle weakness as her primary symptom, hypothyroid symptoms of 3-month duration and a significantly raised creatine kinase. Read More

Metab Brain Dis 2019 12 22;34(6):1565-1575. Epub 2019 Jul 22.

Pediatric Neurology Unit, V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy.

Mutations in the thyroid hormone transporter MCT8 cause severe intellectual and motor disability and abnormal serum thyroid function tests, a syndrome known as MCT8 deficiency (or: Allan-Herndon-Dudley syndrome, AHDS). Although the majority of patients are unable to sit or walk independently and do not develop any speech, some are able to walk and talk in simple sentences. Here, we report on two cases with such a less severe clinical phenotype and consequent gross delay in diagnosis. Read More

J Med Case Rep 2019 Jun 13;13(1):180. Epub 2019 Jun 13.

Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland.

Introduction: The clinical picture of hypothyroidism, including neurological symptoms, can be multiform, which may delay or hamper the correct diagnosis.

Case Presentation: We present an uncommon clinical presentation of a 38-year-old Caucasian man with mild facial palsy on the left side, uvular deviation to the left with preserved gag reflex, tongue deviation to the left, lingual dysarthria, and xerosis by severe hypothyroidism. Blood tests on admission showed elevated serum creatinine of 151 μmol/L (glomerular filtration rate 47 ml/min/1. Read More

World J Clin Cases 2019 May;7(10):1177-1183

Department of Endocrinology, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou 310016, Zhejiang Province, China.

Background: Small cell lung cancer (SCLC) accounts for 15% of lung cancers, and it commonly expresses peptide and protein factors that are active as hormones. These secreting factors manifest as paraneoplastic disorders, such as ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS). The clinical features are abnormalities in carbohydrate metabolism, hypokalemia, peripheral edema, proximal myopathy, hypertension, hyperpigmentation, and severe systemic infection. Read More

Orphanet J Rare Dis 2019 05 22;14(1):112. Epub 2019 May 22.

Department of Dermatology, Hedi Chaker Hospital, Sfax, Tunisia.

Background: Chanarin-Dorfman syndrome (CDS) is a rare syndromic disease related to an accumulation of triacylglycerol in most organs. The aim of our study was to investigate various organs in a large series of CDS patients.

Results: We report for the first time thyroid function impairment in CDS. Read More

Indian J Med Res 2019 Jan;149(1):47-50

Department of Clinical Immunology & Rheumatology, Christian Medical College & Hospital, Vellore, India.

Background & Objectives: : Fibromyalgia syndrome (FMS) is one of the most common chronic pain conditions of unknown aetiology. Mitochondrial dysfunction has been reported in FMS with some studies reporting the presence of mitochondrial mutation namely A3243G, which also causes mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes. This pilot study was conducted to assess this mutation and also detect large deletions in mitochondrial DNA (mtDNA) in patients with FMS. Read More

BMC Endocr Disord 2019 May 22;19(1):52. Epub 2019 May 22.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.

Background: Hypothyroidism, one of the prevalent endocrine disorders worldwide, has a broad spectrum of clinical manifestations, from an asymptomatic condition to myxedema coma. Although the majority of patients with hypothyroidism have minor clinical symptoms, which are recovered with levothyroxine treatment, some patients occasionally do experience fatal complications. Here we report, for the first time, the case of a patient who had hypothyroidism with simultaneous occurrence of rhabdomyolysis with acute kidney injury, moderate pericardial effusion, and sudden sensorineural hearing loss. Read More

Cureus 2019 Mar 6;11(3):e4195. Epub 2019 Mar 6.

Internal Medicine, Dow University of Health Sciences, Karachi, PAK.

Hoffmann's syndrome (HS) is a rare manifestation of hypothyroidism myopathy that presents with weakness, stiffness, and eventually pseudohypertrophy of muscles, especially calf muscles. We report a case of a 28-year-old male who presented with the history of generalized weakness with swelling in lower limbs and gradual progressive facial puffiness for the past few years. Physical examination of our patient showed diffuse bilateral pseudohypertrophy of deltoid and calf muscles with positive Gowers' sign (GS). Read More

BMC Neurol 2019 May 3;19(1):87. Epub 2019 May 3.

Department of Rheumatology and Clinical Immunology, The Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Avenue Wuhua District, Kunming, 650101, Yunnan, China.

Background: Sturge-Weber syndrome (SWS) is a rare and sporadic congenital neurocutaneous disorder, that is characterized by facial venous capillary malformation (port-wine birthmark), leptomeningeal venous malformation (angiomatosis), glaucoma, and neurologic problems. SWS can comorbid with other disorders in some patients, however, muscular abnormalities have still not been reported in patients with SWS.

Case Presentation: A forty-one-year-old Chinese female who had left side port-wine stain, ipsilateral glaucoma, and hypothyroidism was included in the present study. Read More

J Oncol Pharm Pract 2020 Jan 16;26(1):224-227. Epub 2019 Mar 16.

Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, USA.

Purpose: Nivolumab is a fully human IgG4 programmed death 1 immune checkpoint inhibitor (ICI) antibody that has anti-tumor activity by selectively blocking the interaction of the programmed death 1 receptor with its two known programmed death ligands PD-L1 and PD-L2. In doing so, this immune checkpoint inhibitor removes the negative signal stifling T cell activation and proliferation within the tumor microenvironment and demonstrates favorable antitumor activity.

Case Report: We report an interesting case of immune checkpoint inhibitor-induced primary hypothyroidism with associated hypothyroid myopathy in a young patient with surgically resected stage IIIB melanoma receiving adjuvant nivolumab. Read More

Rev Esp Cir Ortop Traumatol 2019 Jul - Aug;63(4):307-312. Epub 2019 Feb 19.

Unidad de Mano, Hospital Asepeyo de Sant Cugat, Sant Cugat del Vallès, Barcelona, España.

Introduction: Trigger finger (TF) is a frequent pathology depending on several factors. The objective of this study was to assess the relationship between multiple TF and systemic or musculoskeletal disorders in a sample of young patients.

Material And Method: A retrospective study was performed of all patients with TF operated in our hospital between 2011 and 2015. Read More

F1000Res 2018 30;7:1154. Epub 2018 Jul 30.

Servicio de Medicina Interna y emergencia, Hospital Regional Lambayeque, Lambayeque, Peru.

Hypokalemic periodic paralysis (HypoKPP) is characterized by transient episodes of flaccid muscle weakness. We describe the case of a teenaged boy with HypoKPP and hyperthyroidism due to Hashimoto's thyroiditis with initial manifestation of renal tubular acidosis. This combination is rare and little described previously in men. Read More

J Assoc Physicians India 2018 May;66(5):69-70

Chief and Consultant Rheumatologist, Center for Rheumatic Diseases, Pune, Maharashtra.

Introduction: Primary Sjogren's Syndrome (pSS) with Hypokalemic Periodic Paralysis(HPP) whether an association or a different clinical subset needs review.

Methods: Cross-sectional retrospective study of subjects of Primary Sjogren's Syndrome with Hypokalemic Periodic Paralysis(HPP) identified from database maintained at Centre For Rheumatic Diseases, Pune since 1996 with records of over 50000 patients. The diagnosis was clinical. Read More

Arthritis Res Ther 2018 Nov 20;20(1):258. Epub 2018 Nov 20.

Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, ST5 5BG, UK.

Background And Aim: Comorbidities are known to exist in many rheumatological conditions. Polymyalgia rheumatica (PMR) is a common inflammatory rheumatological condition affecting older people which, prior to effective treatment, causes severe disability. Our understanding of associated comorbidities in PMR is based only on case reports or series and small cohort studies. Read More

Medicine (Baltimore) 2018 Oct;97(43):e12938

Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.

Rationale: Antiepileptic drugs (AEDs) are one of the causative drugs of drug-induced hypothyroidism. In most cases, AED-induced hypothyroidism is subclinical and indicated only by abnormalities of free thyroxine (T4) and/or thyroid-stimulating hormone (TSH) levels. Severe symptomatic hypothyroidism following AEDs is rarely reported in the literature. Read More

Endocrinol Diabetes Nutr 2018 Dec 8;65(10):564-570. Epub 2018 Oct 8.

IMDEA-Food, CEI UAM + CSIC, Madrid, España. Electronic address:

Background And Objective: Multiple chemical sensitivity (MCS) is a complex, acquired, chronic syndrome of multifactorial etiology with multiple symptoms. The aim of the study was to assess the nutritional habits, dietary characteristics and physical activity, as well as their determinants, of a population diagnosed with MCS, which may allow for a more precise approach to nutritional improvement.

Patients And Method: A descriptive, cross-sectional study in patients diagnosed with MCS. Read More

J Am Acad Orthop Surg 2019 Apr;27(7):e319-e323

From the Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA.

Introduction: Risk factors for stiffness after arthroscopic rotator cuff repair (RCR) have been limited to studies with small patient numbers. The objective is to determine patient-related risk factors for stiffness after RCR.

Methods: The PearlDiver database was queried from 2007 to 2015 for patients undergoing isolated arthroscopic RCR. Read More

Endocrinol Diabetes Metab Case Rep 2018 26;2018. Epub 2018 Jul 26.

New Cross Hospital, Wolverhampton, UK.

Myopathy is a well-known complication of hypercortisolism and commonly involves proximal lower-limb girdle. We report a rare case of Cushing's syndrome in a 60-year-old female presenting with significant respiratory muscle weakness and respiratory failure. She had history of rheumatoid arthritis, primary biliary cirrhosis and primary hypothyroidism and presented with weight gain and increasing shortness of breath. Read More

Dtsch Med Wochenschr 2018 Aug 7;143(16):1174-1180. Epub 2018 Aug 7.

Triiodothyronine (T3) is a key regulator of bone, muscle and articular cartilage. Musculoskeletal symptoms of hyperthyroidism include loss of bone mass finally leading to osteoporosis and weakness of the skeletal musculature. Hypothyroidism on the other side frequently leads to muscle stiffness and cramping and, occasionally, results in rhabdomyolysis. Read More

Radiology 2018 10 7;289(1):28. Epub 2018 Aug 7.

From the Department of Interventional and Diagnostic Radiology, Gold Coast University Hospital, 1 Hospital Blvd, Southport 4215, Queensland, Australia.

Georgian Med News 2018 Jun(279):155-161

Tbilisi State Medical University, Department of Pharmacotherapy, Georgia.

The review analyzes the literature data, which covers the intolerance of statins associated with myopathy. The article gives a definition of statin intolerance, analyzed data from a randomized, controlled trials, where are indicated frequency of statin-associated myopathy, its symptoms in juxtaposition with an increase in creatine kinase activity. It is noted that the frequency of complications depends on the applied statin, its dose, duration, the use of other risk factors that contribute to the development of myopathy. Read More

Rev Med Brux 2018;39(3):172-174

Service de Médecine interne, Hôpital La Rabta.

Hypothyroidism is exceptionnally revealed by hypertrophic myopathy, known as Hoffmann syndrome. We report two new cases of severe hypothyroidism presenting as hypertrophic myopathy, occurring in two men of 49 and 57 years-old. Read More

Am J Emerg Med 2018 09 7;36(9):1723.e1-1723.e6. Epub 2018 Jun 7.

Department of Urology/Institute of Urology, West China Hospital, Sichuan University, 37 Guo Xue Rd., Chengdu, 610041, Sichuan Province, China. Electronic address:

Introduction: Muscular symptoms, including stiffness, myalgia, cramps, and fatigue, are present in the majority of the patients with hypopituitarism, adrenal insufficiency and hypothyroidism, but rhabdomyolysis, the rapid breakdown of skeletal muscle, is a rare manifestation. In most patients who develop rhabdomyolysis, precipitating factors, such as strenuous exercise or use of lipid-lowering drugs, can be identified.

Case Report: We report the case of a 23-year-old male with primary hypopituitarism who developed acute renal impairment (AKI) with rhabdomyolysis after strenuous physical activity (push-ups). Read More

Diabet Med 2018 10;35(10):1457-1459

Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Trust, London, UK.

Background: Hereditary Neuropathy with liability to Pressure Palsies (HNPP) is an autosomal dominant neuropathy, associated with deletion of the Peripheral Myelin Protein-22 (PMP-22) gene, causing recurrent painless palsies with age of onset between 10 and 30 years old. Only a few cases of Type 2 Diabetes and HNPP have been described and the coexistence of HNPP and Type 1 diabetes has never been reported.

Case Report: A 54-year old man with a history of Type 1 diabetes, managed with continuous subcutaneous insulin infusion (CSII), presented with deterioration of long-standing motor and sensory symptoms, previously attributed to golfer's elbow, diabetic neuropathy and spinal degenerative disease. Read More

J Med Case Rep 2018 May 22;12(1):143. Epub 2018 May 22.

Department of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.

Background: Rhabdomyolysis is a rare but serious complication of lipid-lowering therapy. Statin and fibrate combination increases the risk of rhabdomyolysis possibly by pharmacodynamic interactions. Advanced age, diabetes, hypothyroidism, polypharmacy, and renal impairment are known to increase the risk of rhabdomyolysis. Read More