Zhang GF, Rong CM, Li W, Wei BL, Han MT, Han QL. Bilateral carpal tunnel syndrome and motor dysfunction caused by gout and type 2 diabetes: A case report. World J Clin Cases 2023; 11(11): 2535-2540 [PMID: 37123306 DOI: 10.12998/wjcc.v11.i11.2535]
Corresponding Author of This Article
Wei Li, MD, Chief Doctor, Professor, Department of Hand and Foot Surgery, Affiliated Hospital of Jining Medical University, No.89 Gu Huai Road, Jining 272029, Shandong Province, China. liweimails@163.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Gao-Feng Zhang, Cun-Min Rong, Wei Li, Ben-Lei Wei, Ming-Tong Han, Qing-Luan Han, Department of Hand and Foot Surgery, Affiliated Hospital of Jining Medical University, Jining 272029, Shandong Province, China
Author contributions: Rong CM contributed to the conception and design of the study; Han MT and Wei BL contributed significantly to the manuscript preparation; Zhang GF obtained information about the cases and wrote the manuscript; Li W and Han QL helped perform the analysis with constructive discussions and provided the final approval for the version of the article to be published.
Supported byScience and Technology Bureau of Jining, No. 2021YXNS115.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Li, MD, Chief Doctor, Professor, Department of Hand and Foot Surgery, Affiliated Hospital of Jining Medical University, No.89 Gu Huai Road, Jining 272029, Shandong Province, China. liweimails@163.com
Received: December 28, 2022 Peer-review started: December 28, 2022 First decision: February 8, 2023 Revised: February 22, 2023 Accepted: March 15, 2023 Article in press: March 15, 2023 Published online: April 16, 2023
Abstract
BACKGROUND
Carpal tunnel syndrome (CTS) has been associated with gout and type 2 diabetes mellitus (T2DM). However, due to insufficient clinical understanding of gout-related CTS and reliance on the diagnostic importance of elevated serum uric acid levels, such cases are prone to missed diagnosis, misdiagnosis, and delayed treatment. In addition, the effect of T2DM on gout - induced carpal tunnel syndrome has not been reported.
CASE SUMMARY
Herein, we present an unusual case of CTS and motor dysfunction caused by miliary tophaceous gout and T2DM. The patient presented to the hand and foot clinic with paresthesia of the fingers of both hands, especially at night. The patient was diagnosed with type 2 diabetes a month ago. Ultrasonography revealed bilateral transverse carpal ligament thickening with median nerve compression during hospitalization. The patient was successfully treated with carpal tunnel decompression and tendon release. The postoperative pathological examination revealed typical gout nodules. This case suggests that the presence of T2DM could accelerate tophi formation and worsen CTS symptoms, although no definitive proof in this regard has been described previously.
CONCLUSION
Tophi formation may most likely cause the co-occurrence of CTS and flexor dysfunction in gout and incipient diabetes patients.
Core Tip: The onset of diabetes in patients with a previous history of hyperuicemia would likely accelerate urate deposition and lead to the exacerbation of carpal tunnel syndrome.
