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      Reply to the Letter to Editor Regarding “An Unusual Case of Critical Illness Polyneuromyopathy”

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          A bstract

          Critical illness myopathy (CIM), critical illness polyneuropathy (CIP), and critical illness polyneuromyopathy (CIPNM) are the group of disorders that are commonly presented as neuromuscular weakness in intensive care unit (ICU) settings. They are responsible for prolonged ICU stay and failure to wean off from mechanical ventilation. 1 We report one such case of young female who was admitted with undiagnosed type I diabetes mellitus with diabetic ketoacidosis with severe hypokalemia with sepsis developed acute-onset quadriplegia and diaphragmatic palsy within 72 hours of ICU admission. Detailed investigation led to the diagnosis of critical illness polyneuromyopathy. In view of high morbidity, mortality, and poor prognosis, a guided approach to diagnoses and treatment in earliest possible duration might give better improvement and outcome of the illness. Despite all the odds, our patient showed good clinical improvement and finally got discharged.

          How to cite this article

          Mahashabde M, Chaudhary GA, Kanchi G, Rohatgi S, Rao P, Patil R, et al. Reply to the Letter to Editor Regarding “An Unusual Case of Critical Illness Polyneuromyopathy”. Indian J Crit Care Med 2020;24(7):604–605.

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          Review of Critical Illness Myopathy and Neuropathy.

          Critical illness myopathy (CIM) and neuropathy are underdiagnosed conditions within the intensive care setting and contribute to prolonged mechanical ventilation and ventilator wean failure and ultimately lead to significant morbidity and mortality. These conditions are often further subdivided into CIM, critical illness polyneuropathy (CIP), or the combination-critical illness polyneuromyopathy (CIPNM). In this review, we discuss the epidemiology and pathophysiology of CIM, CIP, and CIPNM, along with diagnostic considerations such as detailed clinical examination, electrophysiological studies, and histopathological review of muscle biopsy specimens. We also review current available treatments and prognosis. Increased awareness and early recognition of CIM, CIP, and CIPNM in the intensive care unit setting may lead to earlier treatments and rehabilitation, improving patient outcomes.
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            Author and article information

            Journal
            Indian J Crit Care Med
            Indian J Crit Care Med
            IJCCM
            Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine
            Jaypee Brothers Medical Publishers
            0972-5229
            1998-359X
            July 2020
            : 24
            : 7
            : 604-605
            Affiliations
            [1–3,6,7 ]Department of General Medicine, Dr DY Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
            [4,5 ]Department of Neurology, Dr DY Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
            Author notes
            Gangadharam Kanchi, Department of General Medicine, Dr DY Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India, Phone: +91 8801999535, e-mail: gangadharamkanchi@ 123456hotmail.com
            Article
            10.5005/jp-journals-10071-23499
            7482349
            474033ac-a44f-4ee2-a5f3-b995e86611e3
            Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.

            © The Author(s). 2020 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

            History
            Categories
            Letter to the Editor

            Emergency medicine & Trauma
            critical illness myopathy,critical illness polyneuromyopathy,diabetic ketoacidosis (dka)

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