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AB0940 Efficacy and safety of platelet rich plasma peri-neural injection in treatment of diabetic neuropathy: double blind randomized controlled trial
  1. M Hassanien1,
  2. Y Saad1,
  3. A Alawamy2,
  4. WA Khalifa3,
  5. D Abdelkarem4
  1. 1Rheumatology Department
  2. 2Anathesia department Assuit university
  3. 3Internal Medicine
  4. 4Clinical Pathology, Assuit University, assuit, Egypt

Abstract

Background Neuropathy is a common complication of diabetes mellitus (DM) not only leads to an impaired quality of life, but also to an increased morbidity and mortality.Autologous platelet-rich plasma is easy and cost-effective method. Platelet-derived angiogenesis factor capable of stimulating new capillary growth by inducing migration of endothelial cells, influence the process of angiogenesis and revascularisation.

Objectives evaluate the clinical efficacy and safety of perineural PRP injection in the treatment of diabetic neuropathy (DN) compared to tradition medical treatment.

Methods Sixty patients were selected from Endocrinology unit Department of Internal medicine, Assuit university Hospital, Egypt had type II diabetes mellitus neuropathy (DN) of at least 5 years duration of symptoms, regardless of age and gender double blindly divided into two groups, both groups had control blood glucose. Group I underwent PRP preineural injection under ultrasound guidance and group II underwent medical treatment. Baseline pain and nerve conduction study of upper and lower limb nerves and sural nerve conduction studies, F-wave. nerve conduction study were determined at 3 months after the procedure. Primary outcome was the total effective rate. The total effective rate = (the number of patients with significant effect+ the number of patients with effect)/total number of patients. A “significant effect” meant that limb pain, numbness, and fatigue were significantly reduced, nighttime sleep was improved, and NCV from electromyography increased >5 m/s or returned to normal. An “effect” meant that the symptoms mentioned above were relieved, and NCV compared with pre-treatment increased <5 m/s. “Failure” meant that the symptoms did not improve, and there were no changes in NCV electromyography

Results We recruited 60 diabetic patients (type II) with peripheral neuropathy with a mean age 35.27±12.86 years with disease duration of 7.42±3.51 years. Of these, 56% cases with upper limb nerves neuropathy only while the rest 44% had sural nerve plus upper limb nerves neuropathy. Nerve conduction study showed axonal affection in only 26% and all had delayed distal latency and prolonged motor conduction velocities. generalized DN is found in 70% of total patients and 30% of had focal Entrapment of the nerve includes median neuropathy at the wrist 50%, ulnar neuropathy at the elbow 30% and peroneal neuropathy at the knee 20% and no patients had radiculoplexus neuropathies.

Conclusions Autologous platelet-rich plasma is an easy and cost-effective method as a treatment of diabetic peripheral neuropathy.

Disclosure of Interest None declared

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